Ndome Chavone Dougherty, ANP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5005896 Issued in NC

Practice address

2711 Randolph Road
Ste 100
Charlotte, NC 28207-2027

Phone

(704) 342-1900

Fax

(704) 377-0353

NPI assigned

Oct 25, 2012

Last updated

Oct 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Doe Chavone Dougherty Other name

Medicare fee-for-service enrollment

Enrolled in NC

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivx Health of North Carolina P.C.Group PAC ID 2264812866, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ivx Health of North Carolina, P.C.

  dba IVX Health

  • Clinic/Center
  • Matthews, NC
  • NPI 1376290239
  Medicare reassignment Care Compare group NPD
• Carolina Oncology Specialist PA

  • Hematology & Oncology Physician
  • Charlotte, NC
  • NPI 1467406736
  NPD

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1548513690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH ROAD",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072027",
            "telephone_number": "704-342-1900",
            "fax_number": "704-377-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH ROAD",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072027",
            "telephone_number": "704-342-1900",
            "fax_number": "704-377-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "NDOME",
        "middle_name": "CHAVONE",
        "name_prefix": "Miss",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005896",
            "primary": true
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "NC",
            "license": "5005896",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOE",
            "last_name": "DOUGHERTY",
            "middle_name": "CHAVONE",
            "prefix": "MISS",
            "credential": "ANP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Double Vision Inc (Northlake Optical)
• Jennifer Douds, OT
• Dougherty Villalobos Chiropractic, PLLC (Outbound Chiropractic)
• Connor Dougherty, DC
• Kathleen Mary Dougherty, CCC-SLP
• Regan Dougherty
• Richard Allen Dougherty, MD
• Jenny L Doughty, PHARMD
• Douglas Yoch, Inc. (Stanley Specialty Pharmacy)
• Arianna Lee Douglas

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.