Individual provider Active NPI

Devin Lee Daugherty, DPM

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
National Provider Identifier
1780777904
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00846 Issued in GA
Practice address
2800 N Oak St
Valdosta, GA 31602-1716
Phone
(229) 244-1211
Fax
(229) 244-2721
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00846 GA Primary

Addresses

Primary practice location

2800 N Oak St
Valdosta, GA 31602-1716

Mailing address

2800 N Oak St
Valdosta, GA 31602-1716
Phone (229) 244-1211

Other identifiers 1

IdentifierTypeStateIssuer
0000789709AMedicaidGA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130212000383 GA Practitioner - Podiatry 1254585623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valdosta Foot and Ankle Clinic, P.C.Group PAC ID 1658362439, 2 clinicians

Practice addresses (Care Compare)

2800 N Oak St
Valdosta, GA 31602-1716
Phone (229) 224-1211

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue855
Removal or shaving of skin growth137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00846GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Foot & Ankle Clinic, P.C. Foot & Ankle Surgery CurrentSince Jul 20, 1998 Accepting new patients
Valdosta Foot & Ankle Surgery Center, P.C. CurrentSince May 18, 2008 Accepting new patients

Locations

2800 N Oak St
Valdosta, GA 31602
Phone (229) 244-1211

Interoperability endpoints

  • Direct secure messaging: devindaugherty@vfacc.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1780777904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-244-1211",
            "fax_number": "229-244-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-244-1211",
            "fax_number": "229-244-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "DEVIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "00846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000789709A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.