Active NPI
Katherine Haley Doherty, ATC, LAT
- Athletic Trainer
- Concord, MA
National Provider Identifier
1366636698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 01856
- Practice address
- 1400 Lowell Rd
Concord, MA 01742-5210 - Phone
- (978) 402-1473
- NPI assigned
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 01856 | MA | Primary |
Addresses
Primary practice location
1400 Lowell Rd
Concord, MA 01742-5210
Mailing address
21 Bird St
Woburn, MA 01801-3201
Phone (781) 718-4491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01856 | MA | MD | Computed Tomography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417996800000",
"number": "1366636698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 BIRD ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018013201",
"telephone_number": "781-718-4491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 LOWELL RD",
"city": "CONCORD",
"state": "MA",
"postal_code": "017425210",
"telephone_number": "978-402-1473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "KATHERINE",
"middle_name": "HALEY",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-29",
"last_updated": "2014-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "01856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.