John Joseph Doherty, P.T., A.T.C.

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

05001844A Issued in IN

Practice address

1950 45TH Ave
Suite 200
Munster, IN 46321-3917

Phone

(219) 922-8188

Fax

(219) 922-8502

NPI assigned

Aug 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1700079837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 45TH AVE",
            "address_2": "SUITE 200",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213917",
            "telephone_number": "219-922-8188",
            "fax_number": "219-922-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 45TH AVE",
            "address_2": "SUITE 200",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213917",
            "telephone_number": "219-922-8188",
            "fax_number": "219-922-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.T., A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IN",
            "license": "05001844A",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000225A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryanhthu DO, D.O.
• Danielle Renee Dobkowski
• Marris Taylor Dobosz, RN
• Erica Dockens, LCSW, RN
• Reina Doetterl
• Michael John Doherty, ATC, LAT, DPT
• Patricia E Donovan, MSW, LSW
• Kathleen Doran
• Devang Doshi, M.D.
• Kalpana H Doshi, M.D.

• Sports Physical Therapist in Munster, IN
• Providers in Munster, IN by specialty
• Sports Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.