Individual provider Active NPI

Emily H Dougherty, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1528380870
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN14776 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone
(423) 431-6111
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN14776 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other practice location 1

2204 Pavilion Dr Ste 300
Kingsport, TN 37660-4653
Phone (423) 857-6300

Other practice location 2

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Other identifiers 1

IdentifierTypeStateIssuer
1518377MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000560 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698805281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Anesthesia Solutions IncGroup PAC ID 7315200664, 19 clinicians

Practice addresses (Care Compare)

320 Bristol W Blvd
Suite 1a
Bristol, TN 37620-8773
Phone (423) 639-0941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN14776TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Solutions Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 15, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jul 1, 2019 Accepting new patients
Meadowview ASC, LLC PastSince Feb 15, 2023 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

320 Bristol West Blvd
Ste 1A
Bristol, TN 37620
Phone (423) 758-1030

103 W Stone Dr
Kingsport, TN 37660
Phone (423) 224-4050

10425 Wallace Alley St
Kingsport, TN 37663
Phone (423) 282-9011

130 W Stone Dr
Kingsport, TN 37660

2033 Meadowview Ln
Ste 210
Kingsport, TN 37660
Phone (423) 343-7820

2000 Brookside Dr
Kingsport, TN 37660
Phone (423) 857-7144

Dept 888618
Knoxville, TN 37995

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1528380870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2204 Pavilion Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604653",
            "country_code": "US",
            "telephone_number": "423-857-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042277",
            "country_code": "US",
            "telephone_number": "423-302-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "EMILY",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN14776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518377",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.