MR. MATTHEW JEFFREY DOHERTY (NPI# 1013439215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013439215 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW JEFFREY DOHERTY |
| Credential | CRNA |
| Practice Address |
12221 N Mopac Expy Austin TX 78758-2401 |
| Mailing Address |
8000 E Maplewood Ave Ste 200 Greenwood Village CO 80111-4727 |
| Practice Telephone | 5129011000 |
| Mailing Telephone | (856) 308-7399 |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | AP134789 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356501068 | Matthew T. Doherty | Radiology | 5424 Discovery Park Blvd, Williamsburg, VA 23188 | 2008-06-16 |
| Street Address |
12221 N MOPAC EXPY |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-2401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238534 | Malik M Merchant | Internal Medicine | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2005-07-11 |
| 1477151413 | Jessica C. Heim | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-10-13 |
| 1639786387 | Renee Yvonne Vilaire | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-09-28 |
| 1376150052 | Kimberly Marie Labinsky | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-09-28 |
| 1912515123 | Renee Hyder | Nurse Practitioner | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-07-14 |
| 1255963468 | Melanie Marie Vague | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-02-05 |
| 1730728684 | Sally Anne Jung | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2019-12-24 |
| 1831735505 | Sadie Christine Laddusaw | Anesthesiologist Assistant | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2019-11-18 |
| 1003386285 | Lauren Van Orden | Speech-Language Pathologist | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2018-11-29 |
| 1114406246 | Sarah Mcbride | Clinical Nurse Specialist | 12221 N Mopac Expy, Austin, TX 78758 | 2018-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425150 | Paige L Thibodeaux | Nurse Anesthetist, Certified Registered | 1201 W 38th St Ste 570, Austin, TX 78705-1006 | 2020-04-08 |
| 1265969372 | Omar Garcia | Nurse Anesthetist, Certified Registered | 4100 Duval Rd Ste 100, Austin, TX 78759-3550 | 2017-05-19 |
| 1033662754 | Eliza Lacour | Nurse Anesthetist, Certified Registered | 111 Sandra Muraida Way, Apt 13j, Austin, TX 78703-4694 | 2016-07-28 |
| 1427405810 | Austin Gastroenterology Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 4310 James Casey St Ste 4b, Austin, TX 78745-1120 | 2016-05-16 |
| 1568829521 | Monica Natividad | Nurse Anesthetist, Certified Registered | 6104 Belfast Dr, Austin, TX 78723-1835 | 2016-01-21 |
| 1356602007 | Melissa Deshotels | Nurse Anesthetist, Certified Registered | 8140 N. Mopac, #3-210, Austin, TX 78759 | 2012-05-30 |
| 1457640278 | Eag Healthcare LLC | Nurse Anesthetist, Certified Registered | 4330 Gaines Ranch Loop, Suite 220, Austin, TX 78735-6733 | 2011-04-01 |
| 1285769505 | Breanna D. Sweeney | Nurse Anesthetist, Certified Registered | 8140 N Mo Pac Expy Ste 3-210, Austin, TX 78759-8862 | 2007-02-23 |
| 1538205810 | Linda Tetrick | Nurse Anesthetist, Certified Registered | 1250 Capitol of Texas Hwy S, Bldg 3 Suite 380, Austin, TX 78746 | 2007-01-30 |
| 1467488874 | Sharon Brinker Heiss | Nurse Anesthetist, Certified Registered | 900 Old Koenig Ln, Austin, TX 78756-1528 | 2006-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.