NPIMap

Individual provider Active NPI

Richard Allen Dougherty, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1629068515
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9300686 Issued in NC
Practice address
10450 Park Rd
Ste 200
Charlotte, NC 28210-8505
Phone
(704) 541-9002
Fax
(704) 542-6701
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9300686 NC Primary

Addresses

Primary practice location

10450 Park Rd
Ste 200
Charlotte, NC 28210-8505

Mailing address

10450 Park Rd
Ste 200
Charlotte, NC 28210-8505
Phone (704) 541-9002

Other identifiers 1

IdentifierTypeStateIssuer
8929076MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000282 NC Practitioner - Internal Medicine 9830276377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Forsyth Medical Group, LLCGroup PAC ID 3678478054, 47 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

10450 Park Rd
Suite 200
Charlotte, NC 28210-8403
Phone (704) 541-9002

10450 Park Rd
Suite 200
Charlotte, NC 28210-8546
Phone (704) 541-9002

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

27 Doctors Dr
Hendersonville, NC 28792-7209
Phone (828) 687-3800

Hospital & facility affiliations

  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9300686NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Medical Group, LLC Internal Medicine Current Accepting new patients
Forsyth Medical Group, LLC Internal Medicine CurrentSince Aug 25, 2025 Accepting new patients
Forsyth Medical Group LLC CurrentSince Aug 25, 2025 Accepting new patients
Richard a. Dougherty, MD, PA Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients
Forsyth Memorial Hospital Inc Past Accepting new patients
Forsyth Medical Group, LLC Internal Medicine Past Accepting new patients

Locations

10450 Park Rd
Ste 200
Charlotte, NC 28210
Phone (704) 541-9002

27 Doctors Dr
Hendersonvlle, NC 28792
Phone (828) 687-3800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5609/brand/1/csg/1/fhir/r4
  • Direct secure messaging: richard.dougherty.1@27575.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1629068515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 PARK RD",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108505",
            "telephone_number": "704-541-9002",
            "fax_number": "704-542-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 PARK RD",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108505",
            "telephone_number": "704-541-9002",
            "fax_number": "704-542-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9300686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8929076",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.