Individual provider Active NPI

Kasey Dougherty, DPT

  • Physical Therapist
  • Waukee, IA
National Provider Identifier
1881347375
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
111485 Issued in IA
Practice address
1025 SE Tallgrass LN Ste 120
Waukee, IA 50263-6817
Phone
(515) 875-9706
Fax
(515) 875-9707
NPI assigned
Feb 3, 2022
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 111485 IA Primary

Addresses

Primary practice location

1025 SE Tallgrass LN Ste 120
Waukee, IA 50263-6817

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9925

Other practice location 1

1410 SW Tradition Dr Ste 290
Ankeny, IA 50023-9188
Phone (515) 875-9706

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaseydougherty@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220209002732 IA Practitioner - Physical Therapist in Private Practice 9537552856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1025 SE Tallgrass LN
Suite 120
Waukee, IA 50263-6817
Phone (515) 875-9706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111485IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC CurrentSince Mar 14, 2022 Accepting new patients
The Iowa Clinic, PC CurrentSince Mar 14, 2022 Accepting new patients

Locations

1410 SW Tradition Dr
Ste 290
Ankeny, IA 50023

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

1025 SE Tallgrass Ln
Ste 120
Waukee, IA 50263

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Interoperability endpoints

  • Direct secure messaging: kaseydougherty@tic.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1881347375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE TALLGRASS LN STE 120",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502636817",
            "telephone_number": "515-875-9706",
            "fax_number": "515-875-9707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 SW Tradition Dr Ste 290",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500239188",
            "country_code": "US",
            "telephone_number": "515-875-9706",
            "fax_number": "515-875-9718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KASEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "111485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaseydougherty@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1410 SW Tradition Dr Ste 290",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500239188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.