MRS. MARY JO DOUGHERTY PA - C NPI 1578602017

NPI Information

  • NPI: 1578602017
  • Provider Name: MRS. MARY JO DOUGHERTY, PA - C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 700 OAK GROVE RD
    CHESAPEAKE, VA
    ZIP 23320
  • Phone: (757) 977-8500

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NPI Details

MRS. Mary Jo Dougherty, PA - C is a medical physician assistant in Chesapeake, 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:

700 OAK GROVE RD
CHESAPEAKE, VA
ZIP 23320-728
Phone: (757) 977-8500
Fax: (757) 904-1703

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 8/10/2024.

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
1363AM0700XPhysician AssistantMedicalC5-0000574DELAWARENo
2363AM0700XPhysician AssistantMedical0110003585VIRGINIAYes
3363AM0700XPhysician AssistantMedicalMA052848PENNSYLVANIANo

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: 3/30/2025

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