Sean Roger Doherty, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9349 Issued in MA

Practice address

484 Main St
Worcester, MA 01608-1893

Phone

(800) 244-2756

Fax

(508) 831-9768

NPI assigned

Nov 7, 2017

Last updated

Nov 7, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1629581046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 SOUTH ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311117",
            "telephone_number": "508-304-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 MAIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "800-244-2756",
            "fax_number": "508-831-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "SEAN",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Dogah
• Christine Marie Doherty, RN
• Laura A Doherty, MS, SLP
• Meaghan C. Doherty, M.D.
• Robert Michael Doherty, M.S.W
• David Emery Doiron, DMIN LIC PSY
• Chelsea Jenna Dolan-Grushkin
• Alexis Blair Dolan, LCSW
• Courtney Erin Dolan
• Joan Dolan, NP

• Physical Therapy Assistant in Worcester, MA
• Providers in Worcester, MA by specialty
• Physical Therapy Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.