Individual provider Active NPI

Anthony Christopher Dougherty, M.D.

  • Internal Medicine Physician
  • Columbus, GA
National Provider Identifier
1396741112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
030452 Issued in GA
Practice address
3000 Schatulga Rd
Columbus, GA 31907-3117
Phone
(706) 568-5000
NPI assigned
Jun 27, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 030452 GA Primary

Addresses

Primary practice location

3000 Schatulga Rd
Columbus, GA 31907-3117

Mailing address

8051 Chapel Lake Dr
Midland, GA 31820-3527
Phone (706) 568-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000871 GA Practitioner - Internal Medicine 2466585542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
030452GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince May 14, 2010 Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Department of Behavioral Health and Developmental Disabilities CurrentSince May 14, 2010 Accepting new patients
Georgia Department of Human Resources Past Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3000 Schatulga Rd
Columbus, GA 31907
Phone (706) 568-5202

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396741112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 CHAPEL LAKE DR",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203527",
            "telephone_number": "706-568-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SCHATULGA RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319073117",
            "telephone_number": "706-568-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ANTHONY",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "030452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.