Mikayla Dougherty

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013770A Issued in IN

Practice address

1941 Virginia Ave
Connersville, IN 47331-2879

Phone

(765) 827-7964

NPI assigned

Dec 12, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reid Physician Associates, Inc

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD
• Reid Physician Associates, Inc.

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1376350579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 W 200 S",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461738598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312879",
            "telephone_number": "765-827-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MIKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013770A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crossroads Healing Center LLC
• Crossroads Healing Center LLC
• Cutting Edge Physical Therapy Limited Partnership
• Cutting Edge Physical Therapy Limited Partnership
• Eric J. Djenge, MD
• Dr. Brian J. Altman & Associates, P.C.
• Dr. Tom Christie Family Dentistry PC
• Bradley M Dubois, MD
• James Lowell Dunn, RPH
• Eastern Indiana Pediatric Dentistry, LLC

• Physical Therapist in Connersville, IN
• Providers in Connersville, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.