Renee M Doherty, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704177783 Issued in MI

Practice address

4760 Fashion Square Blvd Ste L-1
Saginaw, MI 48604-2620

Phone

(989) 282-4003

Fax

(888) 491-7220

NPI assigned

Aug 31, 2010

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Careconnectmd Michigan PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dearborn, MI
  • NPI 1477288348
  Medicare reassignment NPD
• Careline Palliative Care LLC

  dba Optimal Care Physician Services

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jackson, MI
  • NPI 1801367073
  Medicare reassignment NPD
• Northview Health Specialists, PLLC

  dba Optimal Care Physician Services

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1629558978
  Medicare reassignment NPD
• Northview Medical House Calls PLC

  dba Careline Physician Services

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1336447002
  Medicare reassignment NPD
• Careline Hmi300 LLC

  dba Optimal Care Hospice

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1770257818
  NPD
• Premier Heart Associates, Inc

  • Cardiovascular Disease Physician
  • Beavercreek, OH
  • NPI 1538188735
  NPD (past)

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1891001681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "989-633-1400",
            "fax_number": "517-212-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 FASHION SQUARE BLVD STE L-1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042620",
            "telephone_number": "989-282-4003",
            "fax_number": "888-491-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704177783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE",
            "identifier": "4704177783",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pauline DO
• Natalie Michelle Doan, LLMSW
• Helen Lee Dodge
• Kaylea Doering, LMSW
• Kevin Doerzman
• Shelby Lynn Dole, BCBA
• Carol A. Doman, LMSW, BCD, LMFT
• Barbara Domina, MSW
• Angie F Domingo, M.D.
• Buena Dominguez, DMD,MS

• Nurse Practitioner in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.