Individual provider Active NPI

Erin L Dougherty, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1558962191
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011458 Issued in DE
Practice address
4755 Ogletown Stanton Rd Ste 2E99
Newark, DE 19718-2200
Phone
(302) 733-5982
Fax
(302) 733-6081
NPI assigned
Nov 2, 2020
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA105199 MD
Physician Assistant 363A00000X C5-0011458 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 2E99
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd FL 3
Newark, DE 19718-2200
Phone (302) 733-3475

Other practice location 1

4755 Ogletown Stanton Rd Fl 3
Newark, DE 19718-2200
Phone (302) 733-3475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201116002687 DE Practitioner - Physician Assistant 4789095126 Reassigns benefits to 2 organizations
I20210816000622 MD Practitioner - Physician Assistant 4789095126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-5982

774 Christiana Rd
Suite 201
Newark, DE 19713-4221
Phone (302) 623-3017

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA105199MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Jun 1, 2021 Accepting new patients
Christiana Care Health Services Inc CurrentSince Nov 12, 2020 Accepting new patients
Union Hospital of Cecil County Inc CurrentSince Jun 1, 2021 Accepting new patients
Christiana Care Health Services Inc CurrentSince Sep 16, 2024 Accepting new patients
Christiana Care Health Services Inc CurrentSince Nov 12, 2020 Accepting new patients
Union Hospital of Cecil County Past Accepting new patients

Locations

4745 Stanton Ogletwn Rd
Newark, DE 19713
Phone (302) 623-7600

4755 Ogletown Stanton Rd
Fl 3
Newark, DE 19718
Phone (302) 733-3475

4755 Ogletown Stanton Rd
Ste 2E99
Newark, DE 19718
Phone (302) 623-3017

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 6

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 1

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1558962191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD FL 3",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-3475",
            "fax_number": "302-325-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 2E99",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-5982",
            "fax_number": "302-733-6081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-3475",
            "fax_number": "302-325-7056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ERIN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "PA105199",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.