Kevin Patrick Dougherty, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT023697 Issued in PA

Practice address

600 Plaza CT Ste a
East Stroudsburg, PA 18301-8263

Phone

(705) 170-5115

Fax

(570) 421-7091

NPI assigned

Sep 9, 2014

Sex

Male

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

Enrolled in NC, PA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Valley Orthopedics PCGroup PAC ID 6901899111, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.dougherty.1@9299.direct.athenahealth.com

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.

• Mountain Valley Orthopedics, P.C.

  • Orthopaedic Surgery Physician
  • East Stroudsburg, PA
  • NPI 1538226519

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Pocono Advanced Medical Clinic PC

  • Specialist
  • East Stroudsburg, PA
  • NPI 1053668798
  NPD

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1376944389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PLAZA CT STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018263",
            "telephone_number": "705-170-5115",
            "fax_number": "570-421-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PLAZA CT STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018263",
            "telephone_number": "705-170-5115",
            "fax_number": "570-421-7091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Fordham Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043773",
            "country_code": "US",
            "telephone_number": "910-484-3114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-09",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Dixon
• Jennifer Donovan, PA-C
• David A Doron, MD
• Chad Dorst II
• Kenneth D Dotson, RPA-C
• Kimberly Downes, DO
• Mikiah Downing, DPT
• Anthony L Drago, EDD
• Daniel Joseph Drago, MS/LPC
• Drupad Bhatt, MD. PC

• Physical Therapist in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.