Active NPI
Mark James Doughtie, ATC
- Athletic Trainer
- Medford, MA
National Provider Identifier
1881705085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 10
- Practice address
- 161 College Ave
Tufts University - Sousens Gym
Medford, MA 02155 - Phone
- (617) 627-5145
- Fax
- (617) 627-2185
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 10 | MA | Primary |
Addresses
Primary practice location
161 College Ave
Tufts University - Sousens Gym
Medford, MA 02155
Mailing address
50 Maplewood Rd
Stoughton, MA 02072
Phone (781) 344-1724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881705085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 MAPLEWOOD RD",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "02072",
"telephone_number": "781-344-1724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 COLLEGE AVE",
"address_2": "TUFTS UNIVERSITY - SOUSENS GYM",
"city": "MEDFORD",
"state": "MA",
"postal_code": "02155",
"telephone_number": "617-627-5145",
"fax_number": "617-627-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHTIE",
"first_name": "MARK",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "10",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
- Claire Frances Donnelly, A.T.R., L.M.H.C.
- Erin Brooke Donnelly, PT, DPT, ATC
- Rachel Dorsey, CCC-SLP
- Helder Dos Santos Oliveira, BA
- Diane M Doucette, FNP
- Meghan Colleen Dowd Murray, LICSW
- Dr Anthony W Iraca of Medford Inc
- Dr. Farzad T Parsi DDS PC
- Dr. Richard a Short DMD, Dr. Ronni Ann Schnell DMD
- Dr. Young Park Dental Group - Medford, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.