Jordan Daugherty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004495 Issued in OH

Practice address

9500 Euclid Ave
Desk E19
Cleveland, OH 44195-0001

Phone

(216) 444-1779

Fax

(216) 445-4552

NPI assigned

Nov 7, 2015

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 OR

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

Merit-based Incentive Payment System (MIPS)

Final score

96.85 of 100Reported as group

Quality

84.92

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Medicare reassignment NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1215983200
  Medicare reassignment
• Salem Emergency Physicians Service, PC

  • Emergency Medicine Physician
  • Salem, OR
  • NPI 1063454395
  Medicare reassignment
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1487811048
  NPD
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  NPD (past)
• Cleveland Clinic Florida a Nonprofit Corporation

  • Clinic/Center
  • Weston, FL
  • NPI 1215989298
  NPD (past)

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

{
    "created_epoch": "1446854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446854400000",
    "number": "1760855126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK E19",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-1779",
            "fax_number": "216-445-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK E19",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-1779",
            "fax_number": "216-445-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-07",
        "last_updated": "2015-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raktima Datta, MD
• Jason Daubner, CDCA
• Raquel Dauch, APRN
• Damyra T Daugett
• Dustin Daugherty
• Monica Daugherty, FNP-C
• Kourtney Rachelle Daughters, NP
• Susan Daum, CNS
• Katherine Ann Daunov, RN MSN ANP
• Michael Daunov, DO

• Physician Assistant in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2015; 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.