Timothy Tyler Daugherty, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

2021020540 Issued in MO

Practice address

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Phone

(314) 362-8065

NPI assigned

Aug 3, 2018

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1699253450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE # 8121",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-8065",
            "fax_number": "314-747-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-8065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 S Euclid Ave # 8121",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101010",
            "country_code": "US",
            "telephone_number": "314-362-8065",
            "fax_number": "314-747-1080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-712-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-03",
        "last_updated": "2021-06-18",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2021020540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Lynn Daugherty
• Kristina Daugherty
• Megan Smith Daugherty, MD
• Mia M Daugherty
• Pamela Kiran Daugherty, COTA/L
• Tyler Lee Daugherty
• Victoria Quincy Daugherty, D.D.S.
• Kara Daumueller-Morrell
• Joseph Daus, PH.D.
• Lila Daus, MSW, LCSW

• Student in an Organized Health Care Education/Training Program in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.