Timothy C. Daugherty, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5798 Issued in KY

Practice address

4801 Manslick Rd
Louisville, KY 40216-4097

Phone

(502) 366-0737

Fax

(502) 366-6299

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386658466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 MANSLICK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164097",
            "telephone_number": "502-366-0737",
            "fax_number": "502-366-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MANSLICK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164097",
            "telephone_number": "502-366-0737",
            "fax_number": "502-366-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Lee Daugherty, PHARMACIST
• Evonie Leigh Daugherty, DPT
• James Gregory Daugherty
• Tammy Daugherty
• Taylor Daugherty, MSW
• Kelly L Dauk, MD
• Arthur Steven Daus, M.D.
• Svarit Dave, MD
• Eric A Davenport, RD
• Maurice Davenport Jr.

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.