Timothy Joseph Dougherty, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP08206 Issued in LA

Practice address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724

Phone

(337) 312-8249

Fax

(337) 312-6711

NPI assigned

Feb 25, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.dougherty@1288.direct.myezyaccess.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.

• Imperial Health, LLP

  • Family Medicine Physician
  • Lake Charles, LA
  • NPI 1053352401
  Medicare reassignment Care Compare group NPD
• Calcasieu Cameron Emergency Physician Group LLC

  • Emergency Medicine Physician
  • Sulphur, LA
  • NPI 1699167478
  Medicare reassignment NPD
• Professional Emergency Medicine Management -- Lake Charles LLC

  • Emergency Medicine Physician
  • Lake Charles, LA
  • NPI 1023430766
  Medicare reassignment NPD
• Imperial Health LLP

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lake Charles, LA
  • NPI 1740982115
  NPD

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1487046694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015785",
            "telephone_number": "337-312-8247",
            "fax_number": "337-493-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-312-8249",
            "fax_number": "337-312-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2386611",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Doucet, LOTR
• Kenneth W Doucet, R.PH.
• Lenie T Doucet, LPC
• Mika Shane Doucet, OT
• Cody Alan Dougay, APRN
• Ashlyn Brooke Douglas, SLP
• Darin Doumite, M.D.
• Mitch Dowden, LAT, ATC
• Roberta A Dowden, LCSW
• Theresa Suzanne Dowden

• Family Nurse Practitioner in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.
• 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.