Individual provider Active NPI

Patricia L. Dougherty, N.P.

  • Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1881728061
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024124127 Issued in VA
Practice address
2955 Ivy Rd
Charlottesville, VA 22903-9353
Phone
(434) 243-4720
Fax
(434) 243-4733
NPI assigned
Mar 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024124127 VA Primary

Addresses

Primary practice location

2955 Ivy Rd
Charlottesville, VA 22903-9353

Mailing address

500 Ray C Hunt Dr
Charlottesville, VA 22903-2981
Phone (434) 980-6140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000813 VA Practitioner - Certified Nurse Midwife (CNM) 0547220964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Virginia State Board of Health Current Accepting new patients
Commonwealth of Virginia State Board of Health CurrentSince Dec 23, 2018 Accepting new patients
Commonwealth of Virginia State Board of Health CurrentSince Dec 23, 2018 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

109 Governor St
Fl 13
Richmond, VA 23219
Phone (804) 864-7009

134 Roberts Ave SW
Wise, VA 24293
Phone (276) 328-8000

Organizations & group practices 4

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881728061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RAY C HUNT DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032981",
            "telephone_number": "434-980-6140",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 IVY RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229039353",
            "telephone_number": "434-243-4720",
            "fax_number": "434-243-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "PATRICIA",
        "middle_name": "L.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024124127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.