Kevin S. Dougherty, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

14756A Issued in WY

Practice address

707 Sheridan Ave
Cody, WY 82414

Phone

(307) 578-2000

NPI assigned

Jun 15, 2014

Last updated

Jun 28, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, WY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Rocky Vista University College of Osteopathic Med, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vituity-Wisconsin Em SCGroup PAC ID 2466814538, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cody Regional Health Hospital, Cody, WY, CCN 531312
• St Vincent Hospital Hospital, Green Bay, WI, CCN 520075

Merit-based Incentive Payment System (MIPS)

Final score

84.74 of 100Reported as group

Quality

73.23

Improvement activities

40

Cost

82.42

Merit-based Incentive Payment System (MIPS)

Final score

80.79 of 100Reported as group

Quality

72.82

Promoting interoperability

100

Improvement activities

40

Cost

63.14

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Vituity-Wisconsin Em SC

  • Emergency Medicine Physician
  • Pleasant Prairie, WI
  • NPI 1326730664
  Medicare reassignment Care Compare group NPD
• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Medicare reassignment NPD
• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197
  NPD
• West Park Hospital District

  • Emergency Medicine Physician
  • Basin, WY
  • NPI 1942921937
  NPD
• Vituity-Wisconsin Em SC

  • Emergency Medicine Physician
  • Oconto Falls, WI
  • NPI 1710754296
  NPD
• Vituity-Wisconsin Em SC

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1902673486
  NPD
• West Park Hospital District

  • Multi-Specialty Clinic/Center
  • Cody, WY
  • NPI 1477192243
  NPD (past)

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

• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197

  Hospital

  Care Compare affiliation
• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Care Compare affiliation
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba St Vincent Hospital

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1114908001
  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Sheboygan, WI
  • NPI 1831784636

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Green Bay, WI
  • NPI 1184004236

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Oconto Falls, WI
  • NPI 1750760740

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  dba St. Vincent Regional Cancer Center

  • Hematology & Oncology Physician
  • Sturgeon Bay, WI
  • NPI 1760861751

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1922412279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-578-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726 Shawano Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543033216",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 S Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013526",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KEVIN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-15",
        "last_updated": "2024-06-28",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "68949-21",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021230",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "14756A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dobson
• Stephen Ward Dominick, MSW, LCSW
• Marchand Dondero
• Katie Marie Donham
• Jade N Dorale
• Harley Belle Dove, M.S., CCC-SLP
• Andrew L Dowling
• Dr. Randy Folker ENT and Allergy, PC
• Ethan Ducharme, PA-C
• Tracy D Dunn, NP

• Emergency Medicine Physician in Cody, WY
• Providers in Cody, WY by specialty
• Emergency Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.