Carin Dougherty, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MED-PAC-LIC-24421 Issued in MT

Practice address

601 W Spruce St
Suite C
Missoula, MT 59802-4057

Phone

(406) 329-5746

Fax

(406) 327-1697

NPI assigned

Oct 17, 2008

Last updated

Jun 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdougherty298390@wm.providencedirect.org

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.

• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Nephrology

  • Nephrology Physician
  • Hamilton, MT
  • NPI 1235997958
  NPD
• Marcus Daly Memorial Hospital Corporation

  dba Bitterroot Health - Darby Scripps Clinic

  • Rural Health Clinic/Center
  • Darby, MT
  • NPI 1396191276
  NPD
• RCHP Billings - Missoula LLC

  dba Community Physician Group

  • Specialist
  • Missoula, MT
  • NPI 1376946913
  NPD (past)

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1750533071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W SPRUCE ST",
            "address_2": "SUITE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024057",
            "telephone_number": "406-329-5746",
            "fax_number": "406-327-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W SPRUCE ST",
            "address_2": "SUITE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024057",
            "telephone_number": "406-329-5746",
            "fax_number": "406-327-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "CARIN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "19670",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MED-PAC-LIC-24421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M000009936",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy P Donovan, MD
• Kerry Dopler, CCC-SLP
• Jennifer Rae Doty, P.A.-C
• Margaret Helen Doty, PHARMD
• Lois Doubleday, MA, LPC
• Kristen Lee Dougherty, LCPC
• Sarsfield Patrick Dougherty
• Ann Douglas, PHD
• Amy Marie Downing, P.T.
• Troy Dion Doxey, DC

• Medical Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Medical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.