Mary Dougherty, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

025656 Issued in NY

Practice address

1500 Portland Ave
Rochester, NY 14621-3065

Phone

(585) 697-6000

NPI assigned

Jul 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1982213757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MAIN ST",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145461315",
            "telephone_number": "704-995-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213065",
            "telephone_number": "585-697-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10011 Providence Rd W",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282771561",
            "country_code": "US",
            "telephone_number": "980-245-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MARY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "10144",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Doucette
• Karen Victoria Doucette, LMT
• Angela Catherine Dougherty, NP
• Jamie Dougherty
• Kevin Michael Dougherty, REGISTERED NURSE
• Matthew Cooney Dougherty
• Monica Dougherty, PHARMD
• Paul Edward Dougherty, D.C.
• Suzanne B Dougherty, LCSW
• John Michael Doughton, M.D.

• Occupational Therapist in Rochester, NY
• Providers in Rochester, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.