Mira Daugherty, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

3012025 Issued in KY

Practice address

430 W Main St
Danville, KY 40422-1888

Phone

(502) 219-3488

NPI assigned

Mar 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonhealth LLCGroup PAC ID 2163833476, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonhealth LLC

  dba CommonHealth Recovery

  • Addiction Medicine (Family Medicine) Physician
  • Frankfort, KY
  • NPI 1902425515
  Medicare reassignment Care Compare group NPD
• Ephraim McDowell Health Resource, Inc.

  dba Danville Family Physicians

  • Family Medicine Physician
  • Danville, KY
  • NPI 1487708533
  Medicare reassignment NPD
• Kentucky Services, LLC

  • Marriage & Family Therapist
  • Lexington, KY
  • NPI 1609448059
  Medicare reassignment NPD
• Kentucky Services, LLC

  • Primary Care Nurse Practitioner
  • Lexington, KY
  • NPI 1811602832
  Medicare reassignment NPD
• Ephraim McDowell Health Resource, Inc

  dba Ephraim McDowell Specialty Services

  • Endocrinology, Diabetes & Metabolism Physician
  • Danville, KY
  • NPI 1174484463
  NPD
• Ephraim McDowell Health Resource, Inc.

  dba Liberty Family Medical Center

  • Family Medicine Physician
  • Liberty, KY
  • NPI 1790932812
  NPD
• Commonhealth LLC

  dba CommonHealth Recovery

  • Rural Health Clinic/Center
  • Frankfort, KY
  • NPI 1710821525
  NPD (past)

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1992207088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 DALLAS DR",
            "city": "HUSTONVILLE",
            "state": "KY",
            "postal_code": "404378304",
            "telephone_number": "606-669-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W MAIN ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221888",
            "telephone_number": "502-219-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "MIRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3012025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100522600",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "430 W Main St",
            "city": "Danville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "404221888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danville Surgical Associates PLLC
• Danville Therapeutic Massage (Anita Sowder)
• Danville Value Pharmacy
• Danville Value Pharmacy LLC (Good Neighbor Pharmacy)
• Danville-Boyle County Senior Citizens, Inc
• Dawn Pingleton, DO
• Barbara E Dawson
• Tyler Joel Daylong, OTD, OTR/L
• Kelley 'Corky' Deaton III, DMD
• Glenn J Decker, PT

• Primary Care Nurse Practitioner in Danville, KY
• Providers in Danville, KY by specialty
• Primary Care Nurse Practitioner in Kentucky

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