Shane Anthony Daugherty

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

712 W 3Rd St
Little Rock, AR 72201-2220

Phone

(501) 379-4246

NPI assigned

Nov 18, 2025

Last updated

Nov 18, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Gain, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Rock, AR
  • NPI 1992885180
  NPD (past)

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1790646008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 W 3RD ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722012220",
            "telephone_number": "501-379-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 W 3RD ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722012220",
            "telephone_number": "501-379-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "SHANE",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvin Sidney Dassinger III, M.D.
• Brett Keith Daughdrill
• Cheyenne Summer Daugherty
• James Daugherty, MHPP
• Rachael Nichole Daugherty, APN/NP
• Nicholas Joseph Davanzo, DPT
• Megan Marie Davari, AGACNP-BC
• Davenport Dental, LLC (Markham Street Dental)
• Clarissa Davenport, APRN
• Hannah Davenport, APRN

• Case Manager/Care Coordinator in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.