Jenna Dougherty, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2218 Issued in KS

Practice address

1202 W Maple St
Wichita, KS 67213-3916

Phone

(316) 262-3716

NPI assigned

Jul 23, 2024

Last updated

Jul 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Wichita Family OptometristsGroup PAC ID 0749181584, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Wichita Family Optometrists

  • Optometrist
  • Wichita, KS
  • NPI 1821069220
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1700614674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W MAPLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672133916",
            "telephone_number": "316-262-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W MAPLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672133916",
            "telephone_number": "316-262-3716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "318 N Main St",
            "address_purpose": "LOCATION",
            "city": "Goddard",
            "state": "KS",
            "postal_code": "670528768",
            "country_code": "US",
            "telephone_number": "316-794-2228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JENNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Double Arrow Metabolism, LLC
• Virginia Nola Douds, DOULA
• Doug Chambers DDS, PA
• Amy Dougan, PHARMD
• Emily Caitlyn Dougherty, SLP
• Becky Denise Douglas, LMSW
• Brandon John Douglas
• Amanda Leeann Douglass, CRNA
• Denise Douty, T-LPC
• Christina Alice Dowding

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.