SARA DOUGHERTY NP NPI 1821024480

NPI Information

  • NPI: 1821024480
  • Provider Name: SARA DOUGHERTY, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7302 S BINGHAM JUNCTION BLVD
    MIDVALE, UT
    ZIP 84047
  • Phone: (801) 442-5502

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NPI Details

Sara Dougherty, NP is a family nurse practitioner in Midvale, UT with 29 years of experience. Sara Dougherty, NP NPI is 1821024480. 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:

7302 S BINGHAM JUNCTION BLVD
MIDVALE, UT
ZIP 84047-804
Phone: (801) 442-5502

The NPI 1821024480 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.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 6/24/2006 and was last updated on 12/26/2018.

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
1363L00000XNurse Practitioner120828MISSOURINo
2363LF0000XNurse PractitionerFamilyAPRN002108NEVADANo
3363LF0000XNurse PractitionerFamily10814308-4405UTAHYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100183120AMEDICAIDOKLAHOMA
2173861OTHERMISSOURIANTHEM
3200000240AMEDICAIDKANSAS
4500014122OTHERRR MEDICARE
5V112696OTHERNEVADASMA MEDICARE
61821024480OTHERNEVADASMA MEDICAID
7428623219MEDICAIDMISSOURI

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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