Thomas M Dougherty, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009024720 Issued in MO

Practice address

1019 Skinker Pkwy
156
Saint Louis, MO 63112-2355

Phone

(678) 793-7963

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Douglas County Public Health Services Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gainesville, MO
  • NPI 1598762593
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)
• Alabama Sports Medicine and Ortho Center

  • Orthopaedic Surgery Physician
  • Bham, AZ
  • NPI 1487629101
  NPD (past)
• Andrews Sports Medicine and Orthopaedic Center

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Birmingham, AL
  • NPI 1679617526
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1952403651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 SKINKER PKWY",
            "address_2": "156",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122355",
            "telephone_number": "678-793-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 SKINKER PKWY",
            "address_2": "156",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122355",
            "telephone_number": "678-793-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "29906",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "29906",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29906",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009024720",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2009024720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Dougherty, M.D.
• Cynthia Dougherty
• Kristen Dougherty
• Matthew Dougherty, MD
• Stefanie Brooke Dougherty, D.M.D., M.S.D.
• Douglas a Krauss Inc
• Adam Alexander Douglas
• Breanna Lynn Douglas, LCSW
• Christopher Scott Douglas, MD
• Erica Sarkieshan Douglas, MSW

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.