Alex Doherty

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088

Phone

(904) 245-8910

NPI assigned

Dec 11, 2023

Sex

Male

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 GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Nova Southeastern College of Osteo Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crisp Regional Hospital Inc 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crisp Regional Hospital Hospital, Cordele, GA, CCN 110104

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649

  GA

  Medicare reassignment Care Compare group NPD
• Crisp Regional Hospital, Inc

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  Care Compare group NPD
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1164855755
  Care Compare group
• Crisp Regional Hospital, Inc

  • Rural Health Clinic/Center
  • Cordele, GA
  • NPI 1376750976
  Care Compare group
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1396711099
  Care Compare group
• Crisp Regional Hospital, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cordele, GA
  • NPI 1457329377
  Care Compare group
• Crisp Regional Hospital, Inc

  • Community Based Hospice Care Agency
  • Cordele, GA
  • NPI 1699740498
  Care Compare group
• Crisp Regional Hospital, Inc.

  • Home Health Agency
  • Cordele, GA
  • NPI 1376518118
  Care Compare group
• Crisp Regional Hospital, Inc.

  • Rural Health Clinic/Center
  • Warwick, GA
  • NPI 1790992352
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1740057793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 GATE PKWY W UNIT 421",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "ALEX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Doerner, D.O.
• Ashley Danielle Doerr, MSW
• Vahide M Dogan-Bag, M.D.
• Aisha Lynette Doggette
• Doh Bureau of Laboratories
• Rhiannon Rae Doherty, PMHNP-BC
• Susannah C Doherty, SLP
• Nessreen Dohidel
• Tanya Elizabeth Doidge, P.T.
• Erica Megan Doig

• All providers in Jacksonville, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.