Individual provider Active NPI

Elizabeth Ann Dougherty, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Dover, NH
National Provider Identifier
1447696430
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
24120 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 740-3330
NPI assigned
May 16, 2013
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 24120 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-6562

Other identifiers 1

IdentifierTypeStateIssuer
3141396MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20230822004144 NH Practitioner - Hospice/Palliative Care 1951543354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
University of Massachusetts Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

789 Central Ave
Level2
Dover, NH 03820-2526
Phone (603) 740-3330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24120NHMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Aug 21, 2023 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Aug 21, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

789 Central Ave
#2
Dover, NH 03820
Phone (603) 609-6096

Interoperability endpoints

  • Direct secure messaging: dougherty.elizabeth.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1447696430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-6562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NH",
            "license": "24120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3141396",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.