John F Dougherty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA416 Issued in KY

Practice address

3303 Fern Valley Rd
Louisville, KY 40213-3529

Phone

(502) 964-4889

Fax

(502) 964-9769

NPI assigned

May 26, 2006

Last updated

Jan 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300

  Physician Assistant

  NPD
• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Baptist Health Medical Group Inc

  dba CBC Group Consulting in Blood Disorders & Cancer

  • Hematology & Oncology Physician
  • Louisville, KY
  • NPI 1487984514
  NPD (past)
• Baptist Health Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1073890695

  Occupational Medicine

  NPD (past)
• Baptist Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1568740447
  NPD (past)
• Pulmonary Specialists of Louisville, PSC

  • Pulmonary Disease Physician
  • Louisville, KY
  • NPI 1598819724
  NPD (past)
• Sleep Care Specialist of Louisville

  • Sleep Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1841661410
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421452800000",
    "number": "1487600797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 FERN VALLEY RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402133529",
            "telephone_number": "502-964-4889",
            "fax_number": "502-964-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA416",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": "PA416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002689",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin M Doub, LCSW
• Sable Doucette
• April Nicole Dougherty, DNP, APRN
• Dana Lynn Dougherty, MD
• Diane L Dougherty, ARNP
• Samuel H Dougherty, LCSW
• Shelby Madison Doughty
• Douglas Institute PLLC
• Nicole Douglas-Sarver, CSW
• Aleve Douglas, LPCC

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2015; 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.