Carla Mary Doherty, RPH

Primary specialty

Geriatric PharmacistTaxonomy code 1835G0303X

License

042438 Issued in MO

Practice address

216 Spring Oaks Dr
Ballwin, MO 63011-3836

Phone

(314) 952-8020

NPI assigned

Feb 22, 2019

Last updated

Feb 22, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1801353214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SPRING OAKS DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113836",
            "telephone_number": "314-952-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SPRING OAKS DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113836",
            "telephone_number": "314-952-8020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "785 Henry Ave",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630112736",
            "country_code": "US",
            "telephone_number": "636-527-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "CARLA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MO",
            "license": "042438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa S Dierdorf, LPC
• Jordan Dietl, OT
• Sandra Diver, LCSW
• Katherine G Dodge, DPT
• Robbin R Doermer, D.C.
• Laura Jeep Dougherty, MS CCC SLP
• Mike Downing, CRNA
• Dr Laurie Mecham PC
• Dr Susan Adams
• Kristin Anne Draeger, RN,LCSW

• Geriatric Pharmacist in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Geriatric Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.