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DAVID ALAN DAUGHERTY PA-C NPI 1689648214


NPI Information

NPI: 1689648214
Provider Name: DAVID ALAN DAUGHERTY, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
7601 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804
Phone: (260) 436-8686
Get Directions

David Alan Daugherty, PA-C is a surgical physician assistant in Fort Wayne, IN with 16 years of experience. David Alan Daugherty, PA-C NPI is 1689648214. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7601 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804-133
Phone: (260) 436-8686
Fax: (260) 436-8585

The NPI 1689648214 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of wrist, minimum of 3 views (HCPCS:73110)
  • Injections of tendon sheath, ligament, or muscle membrane (HCPCS:20550)

The enumeration date for this NPI number is 2/13/2006 and was last updated on 11/7/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AS0400XPhysician AssistantSurgical50-002861OHIONo
2363AS0400XPhysician AssistantSurgical10001118AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OPRMEDICAIDINDIANA
2000000626650OTHERINDIANAANTHEM
3132560JJJMEDICARE PININDIANA
41084497OTHEROHIONCCPA
5P00877355OTHERRAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.