Donn M Dougherty, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28871-020 Issued in WI

Practice address

760 Pilgrim Way
Green Bay, WI 54304-5263

Phone

(920) 496-4700

NPI assigned

Jul 3, 2006

Last updated

Feb 26, 2010By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1992735351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045263",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045263",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "DONN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DD406638",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28871-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Dorow
• Kim D Dorsey, MSW APSW
• Kristofer Michael Dosh, M.D.
• Mehul Mahendra Doshi, MD
• Karim Adel Ahmed Mohamed Doughem, MD
• William Scott Dougherty, MD
• Joshua P Douma, CRNA
• Dousman Clinic, S.C.
• Brian Thomas Dovorany, D.C.
• Megan Downing

• Family Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.