Mark William Doughty, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1508 Issued in AK

Practice address

4050 Lake Otis Pkwy Ste 210
Anchorage, AK 99508-5221

Phone

(907) 244-3694

NPI assigned

Feb 5, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart of Eagle River Medical ClinicGroup PAC ID 0345240214, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Heart of Eagle River Medical Clinic

  • Family Medicine Physician
  • Eagle River, AK
  • NPI 1033277041
  Medicare reassignment Care Compare group NPD

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

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1982095444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 KEMPTON HILLS DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995162776",
            "telephone_number": "907-244-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 LAKE OTIS PKWY STE 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085221",
            "telephone_number": "907-244-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTY",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Louise Douds-Paczan, PA-S
• Doug a Vermillion MD
• Marilyn J Dougher, RNC
• Janet Dougherty, SLPA
• William G Dougherty, OT
• Douglas Carter Smith
• Douglas J. Luiten, D.M.D., P.C.
• Donnell Isaiah Douglas
• Earl Douglas III
• Stephanie Lee Douglas, LPN

• Family Nurse Practitioner in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.