MRS. MARY JO DOUGHERTY PA - C NPI 1578602017

NPI Information

NPI: 1578602017
Provider Name: MRS. MARY JO DOUGHERTY, PA - C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1133 FIRST COLONIAL RD
VIRGINIA BEACH, VA
ZIP 23454
Phone: (757) 496-2050
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MRS. Mary Jo Dougherty, PA - C is a medical physician assistant in Virginia Beach, VA. MRS. Mary Jo Dougherty, PA - C NPI is 1578602017. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1133 FIRST COLONIAL RD
VIRGINIA BEACH, VA
ZIP 23454-402
Phone: (757) 496-2050

The NPI 1578602017 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 enumeration date for this NPI number is 2/5/2007 and was last updated on 11/4/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	MA052848	PENNSYLVANIA	No
2	363AM0700X	Physician Assistant	Medical	C5-0000574	DELAWARE	No
3	363AM0700X	Physician Assistant	Medical	0110003585	VIRGINIA	Yes

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

NPI Synchronization or Removal

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