Connor Patrick Doherty, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10004557A Issued in IN

Practice address

3400 Lafayette Rd Ste 200
Indianapolis, IN 46222-1147

Phone

(317) 291-7422

Fax

(317) 291-7433

NPI assigned

Nov 25, 2019

Last updated

Jul 1, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Health Services IncGroup PAC ID 5890696603, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: connor.doherty.1@10844.direct.athenahealth.com

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.

• Open Door Health Services, Inc.

  dba Southway Urgent Center

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1770510240
  Medicare reassignment Care Compare group
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1992924633
  Medicare reassignment
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1104133511
  NPD
• Open Door Health Services, Inc.

  dba Open Door Health Services YMCA

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1376349316
  NPD
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anderson, IN
  • NPI 1508811910
  NPD (past)
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1902851082
  NPD (past)
• Open Door Health Services, Inc.

  dba Open Door Family Planning

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1912080060
  NPD (past)

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

• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1831735851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 W 56th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462541695",
            "country_code": "US",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473052465",
            "country_code": "US",
            "telephone_number": "765-287-3087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "CONNOR",
        "middle_name": "PATRICK",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-25",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004557A",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096004117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex James Doermann, M.D.
• Tyler Doerner
• Ali M Dohan, M.D.
• Anna Mary Doherty, PA
• Clare Kelly Doherty, NP
• Maureen E.T. Doherty
• Sarah Doherty
• Savannah Doherty, MA, CCC-SLP/L
• Haseeba Dojki-Khan, MD
• Bridget Brennan Dolan, RPH

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.