TIMOTHY DOUGHERTY (NPI# 1164487344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164487344 |
| Entity Type | Individual |
| Full Name | TIMOTHY DOUGHERTY |
| Practice Address |
636 Del Prado Blvd S Cape Coral FL 33990-2668 |
| Mailing Address |
6896 W Snowville Rd Brecksville OH 44141-3214 |
| Practice Telephone | 2397726513 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2008-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME76221 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 44660 | 01 |
| FL | AETNA | 7939666 | 01 |
| FL | AMERIGROUP | 221582 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629232723 | Timothy Russell Dougherty Jr. | Internal Medicine | 4660 Kenmore Ave Ste 100, Alexandria, VA 22304-1306 | 2008-07-17 |
| 1205498102 | Timothy Dougherty | Radiology | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2019-07-01 |
| 1487046694 | Timothy Joseph Dougherty | Nurse Practitioner | 501 Dr Michael Debakey Dr, Lake Charles, LA 70601-5724 | 2015-02-25 |
| 1093045452 | Timothy Dougherty | Counselor | 1437 S Belcher Rd, Clearwater, FL 33764-2829 | 2010-01-07 |
| Street Address |
636 DEL PRADO BLVD S |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33990-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598758674 | Lmr Imaging | Radiology | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2005-08-24 |
| 1912530809 | Victoria Lynn Rivera | Nurse Practitioner | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2020-02-19 |
| 1104309236 | Kayley Ann Oliveri | Emergency Medicine | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2018-09-14 |
| 1699288050 | Kacie Ferracci | Pharmacist | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2017-11-08 |
| 1790160653 | Ebele Ezenwa | Nurse Practitioner | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2015-07-21 |
| 1285018903 | Edgar Joseph Turner IIi | Pharmacist | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2015-07-13 |
| 1740662071 | Jennifer Moss | Nurse Practitioner | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2015-06-23 |
| 1093107195 | Lee Memorial Health System | Pharmacy | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2015-02-26 |
| 1033534995 | Kelsie Phillips | Nurse Practitioner | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2014-02-28 |
| 1821410549 | Steven Tull | Respiratory Therapist, Registered | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2014-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902462 | Shahida Rafiq | Pharmacist | 1619 Delprado Blvd, Cape Coral, FL 33990 | 2020-11-03 |
| 1386259208 | Hope of Life Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 2328 Hancock Bridge Pkwy 1st Fl Ste 114-e, Cape Coral, FL 33990 | 2020-09-09 |
| 1669001814 | Jamie Lindon Kohl | Specialist/Technologist | 605 Se 13th Ct, Cape Coral, FL 33990 | 2020-04-08 |
| 1548809551 | Medical Risk Solutions | Family Medicine | 1020 Cultural Park Blvd, Cottage #7, Cape Coral, FL 33990 | 2019-12-23 |
| 1013495175 | Sunshine Assisted Living Home Care Facility. | Assisted Living Facility | 1422 Se 23rd Ter., Crape Coral, FL 33990 | 2018-08-01 |
| 1215429279 | Five Star Homecare LLC | Adult Companion | 629 Se 10th Pl, Cape Coral, FL 33990 | 2018-06-05 |
| 1730679192 | Amanda Tiana Bright | Developmental Therapist | 1507 Se 18th St, Cape Coral, FL 33990 | 2018-05-11 |
| 1487170908 | Natalie Diaz | Behavior Technician | 317 Se 16th Place, Cape Coral, FL 33990 | 2017-08-16 |
| 1679097273 | Centro Medico LLC | Clinic/Center | 1425 Viscaya Pkwy Ste 101, Cape Coral, FL 33990 | 2017-07-26 |
| 1629506308 | Besties LLC | Adult Companion | 518 Se 20th Ct, Cape Coral, FL 33990 | 2017-05-25 |
| Find all providers in zip 33990 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124223581 | Tyler Charles Ensley | Emergency Medicine | Cape Coral Hospital, 636 Del Prado Blvd, Cape Coral, FL 33990 | 2007-06-17 |
| 1326075797 | Paul J Arnold | Emergency Medicine | 856 Cape Coral Pkwy E, Cape Coral, FL 33904-9081 | 2006-06-28 |
| 1568437077 | Timothy Matthew Everett | Emergency Medicine | 1305 Sw 19th Ln, Cape Coral, FL 33991-3223 | 2006-02-18 |
| 1356330591 | Michael J. Goeden | Emergency Medicine | 1708 Cape Coral Parkway W, Suite 2, Cape Coral, FL 33914 | 2005-10-20 |
| 1821091653 | Keith Lafferty | Emergency Medicine | 636 Del Prado Blvd, Cape Coral, FL 33990 | 2005-05-24 |
| 1104309236 | Kayley Ann Oliveri | Emergency Medicine | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2018-09-14 |
| 1932468766 | Keith Cameron Burley | Emergency Medicine | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2012-05-14 |
| 1437209855 | Ft Myers Physician Pa | Emergency Medicine | 2721 Del Prado Blvd S, Suite 240, Cape Coral, FL 33904-5781 | 2007-01-10 |
| 1376611962 | Cape Coral Emergency Physicians LLC | Emergency Medicine | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2006-12-01 |
| 1790852697 | Pamela M. Perry | Emergency Medicine | 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | 2006-11-29 |
| Find all providers in CAPE CORAL | ||||
| City | CAPE CORAL |
| Zip Code | 33990 |
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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.