Mitchell Reid Dougherty, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12077 Issued in TX

Practice address

13396 Preston Rd
Dallas, TX 75240-5208

Phone

(972) 503-7272

NPI assigned

Aug 29, 2012

Sex

Male

Sole proprietor

No

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 TX

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 1

Specialty

ChiropracticAlso: Sports Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ri Sports Medicine PLLCGroup PAC ID 2567885189, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ri Sports Medicine PLLC

  • Chiropractor
  • Dallas, TX
  • NPI 1639799521
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1992053557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13396 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13396 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752405208",
            "telephone_number": "972-503-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MITCHELL",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alleyna Dougherty, MD
• Amie Lynn Boles Dougherty, PT, DPT
• Doug Michael Dougherty, THM MED LPC
• Jennifer Lynn Dougherty, PH.D.
• Michael Dougherty
• Patrick Kelly Dougherty, MPAS, PA-C
• Dougherty'S Pharmacy Inc.
• Doughertys LTC Pharmacy LLC
• Doughertys Pharmacy Inc
• Doughertys Pharmacy Inc

• Chiropractor in Dallas, TX
• Providers in Dallas, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.