Colleen Marie Dougherty, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP017680 Issued in PA

Practice address

5 S Washington Ave
Jermyn, PA 18433-1121

Phone

(570) 230-0019

Fax

(270) 230-0013

NPI assigned

Aug 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Wright Center Medical GroupGroup PAC ID 6305841230, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleend@thewrightcenter.medentdirect.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.

• The Wright Center Medical Group

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1194739979

  Family

  Medicare reassignment Care Compare group NPD
• The Wright Center Medical Group

  dba The Wright Center For Community Health

  • Federally Qualified Health Center (FQHC)
  • Scranton, PA
  • NPI 1649836941
  NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1609392117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 N IRVING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18510",
            "telephone_number": "570-335-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S WASHINGTON AVE",
            "city": "JERMYN",
            "state": "PA",
            "postal_code": "184331121",
            "telephone_number": "570-230-0019",
            "fax_number": "270-230-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colleenD@thewrightcenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "HISP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5 S Washington Ave",
            "city": "Jermyn",
            "state": "PA",
            "country_code": "US",
            "postal_code": "184331121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bridget Conway, MSW
• Amanda Rose Decesare, CRNP
• J. Anne Nicole De la Fuente Del Rosario, MD
• Maggie O'Hara Dempsey, CRNP
• Cassidy Dorson, MA
• Kathleen Ann Doyle
• Marisa Lynn Duchnik, RDH, PHDHP
• Edward Dzielak, DO
• Lori Grodack, PHDHP
• Renea Hammerman, LSW

• Family Nurse Practitioner in Jermyn, PA
• Providers in Jermyn, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.