NPIMap

Individual provider Active NPI

Larry Justin Doughty, M.D.

  • Pain Medicine Physician
  • Alexandria, LA
National Provider Identifier
1922549211
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
310878 Issued in LA
Practice address
3444 Masonic Drive
Alexandria, LA 71301
Phone
(318) 473-9556
Fax
(318) 441-8339
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 310787 LA
Pain Medicine Physician 208VP0000X 310878 LA Primary

Addresses

Primary practice location

3444 Masonic Drive
Alexandria, LA 71301

Mailing address

3444 Masonic Drive
Alexandria, LA 71301
Phone (318) 473-9556

Other identifiers 1

IdentifierTypeStateIssuer
2440985MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707000431 LA Practitioner - PsychiatryPractitioner - Physical Medicine and Rehabilitation 2365714177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Physical Medicine and Rehabilitation
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid State Orthopaedic and Sports Medicine Center LLCGroup PAC ID 6204892540, 27 clinicians

Practice addresses (Care Compare)

3444 Masonic Dr
Alexandria, LA 71301-3615
Phone 31844183291329

Hospital & facility affiliations

  • Christus Central Louisiana Surgical Hospital Hospital, Alexandria, LA, CCN 190298
  • Christus St Frances Cabrini Hospital Hospital, Alexandria, LA, CCN 190019
  • Lasalle General Hospital Hospital, Jena, LA, CCN 190145
  • Winn Parish Medical Center Hospital, Winnfield, LA, CCN 190090

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
310787LAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid State Orthopaedic & Sports Medicine Center, LLC Physical Medicine & Rehabilitation CurrentSince Aug 1, 2022 Accepting new patients
Mid State Orthopaedic & Sports Medicine Center LLC Physical Medicine & Rehabilitation CurrentSince Aug 1, 2022 Accepting new patients

Locations

3351 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6800

3444 Masonic Dr
Alexandria, LA 71301
Phone (318) 441-8329

429 Rocky Bayou Dr
Ste A
Pineville, LA 71360
Phone (318) 473-9556

Interoperability endpoints

  • Direct secure messaging: jdoughty@midstateortho.emadirect.md

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 and National Provider Directory roles.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1922549211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 MASONIC DRIVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 MASONIC DRIVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTY",
        "first_name": "LARRY",
        "middle_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-12-28",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "310787",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "LA",
            "license": "310878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2440985",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.