MICHAEL SEAN DOHERTY (NPI# 1609313360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609313360 |
| Entity Type | Individual |
| Full Name | MICHAEL SEAN DOHERTY |
| Credential | PA |
| Practice Address |
5171 S Cottonwood St Ste 740 Murray UT 84107-5705 |
| Practice Telephone | 8015079700 |
| Practice Fax Number | 8015079705 |
| Mailing Telephone | 8015079700 |
| Mailing Fax Number | 8015079705 |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2018-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4940 Eastern Ave, Suite A-150, Baltimore, MD 212242735 | 4105500360 | 4105500178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780167171 | Michael Doherty | Technician | 990 Equestrian Dr Apt 3103, Henderson, NV 89002-0904 | 2018-09-11 |
| 1730616574 | Michael John Doherty | Specialist/Technologist | 10133 Devonshire Ln, Munster, IN 46321-4376 | 2017-05-11 |
| 1386634418 | Michael J Doherty | Dentist | 460 Murphy Road, Medford, OR 97504 | 2005-10-28 |
| 1104323658 | Michael L Doherty | Student in an Organized Health Care Education/Training Program | 2601 Ocean Parkway, Brooklyn, NY 11235 | 2018-04-11 |
| 1518371020 | Michael Reardon Doherty | Dentist | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2014-06-12 |
| 1043590540 | Michael Harold Doherty | Student in an Organized Health Care Education/Training Program | 1356 Lusitana St Ste 510, Honolulu, HI 96813-2409 | 2011-08-28 |
| 1770659328 | Michael F Doherty | Internal Medicine | 2400 Mount Zion Parkway, Department of Hematology Oncology, Jonesboro, GA 30236 | 2006-11-27 |
| 1114097482 | Michael Dennis Doherty | Dentist | 580 Main St, Suite 200, Carbondale, CO 81623-2072 | 2006-11-08 |
| 1033299953 | Michael J Doherty | Psychiatry & Neurology | 550 17th Ave, Fifth Floor, Seattle, WA 98122-5788 | 2006-10-16 |
| 1720011695 | Michael Doherty | Radiology | 2500 N State St, Jackson, MS 39216-4500 | 2006-07-07 |
| Street Address |
5171 S COTTONWOOD ST STE 740 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-5705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013187525 | Kyle Andrews Gardner | Emergency Medicine | 5171 S Cottonwood St Ste 740, Murray, UT 84107-5705 | 2008-03-11 |
| 1659855575 | Justin James Peck | Physician Assistant | 5171 S Cottonwood St Ste 740, Murray, UT 84107-5705 | 2018-09-17 |
| 1063992022 | Fernando Rivero | Physician Assistant | 5171 S Cottonwood St Ste 740, Murray, UT 84107-5705 | 2018-08-20 |
| 1497248272 | Betty Anne Harris | Nurse Practitioner | 5171 S Cottonwood St Ste 740, Murray, UT 84107-5705 | 2018-06-07 |
| 1730686668 | Kari Potter | Emergency Medicine | 5171 S Cottonwood St Ste 740, Murray, UT 84107 | 2018-04-08 |
| 1336679430 | John Christopher Jacobs Jr. | Emergency Medicine | 5171 S Cottonwood St Ste 740, Murray, UT 84107-5705 | 2017-06-13 |
| 1922475508 | Angela King | Physician Assistant | 5171 S Cottonwood St Ste 740, Murray, UT 84107 | 2015-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447725247 | Shonti G. Breisch | Physician Assistant | 6150 S Vineway Cir, Murray, UT 84121-1947 | 2018-10-08 |
| 1043705866 | Jeffery Mccleve | Physician Assistant | 5323 S Woodrow St Ste 100, Murray, UT 84107-5842 | 2018-06-25 |
| 1518402098 | Philip John Swink | Physician Assistant | 650 E 4500 S Ste 100, Murray, UT 84107-4536 | 2016-12-20 |
| 1760849657 | Molly Ann Nowill | Physician Assistant | 5169 S Cottonwood St Ste 501a, Murray, UT 84107-6767 | 2016-01-22 |
| 1114399839 | Scott West | Physician Assistant | 5169 S Cottonwood St Ste 510, Murray, UT 84107-6770 | 2015-10-21 |
| 1679901169 | Jennifer Aileen Wight | Physician Assistant | 5169 S Cottonwood St Ste 440, Murray, UT 84107-6774 | 2013-10-22 |
| 1164728960 | Lex Kiyoshi Grimley | Physician Assistant | 5169 Cottonwood St Ste 520, Murray, UT 84107-6767 | 2011-01-27 |
| 1760618730 | Kelly Lynae Richardson | Physician Assistant | 5121 S Cottonwood St Ste 320, Murray, UT 84107-5701 | 2009-06-04 |
| 1184887051 | Meredith Evin Pike | Physician Assistant | 5450 S Green St, Murray, UT 84123-5632 | 2008-07-09 |
| 1215091525 | Matthew M Neddo | Physician Assistant | 5911 S Fashion Blvd, Murray, UT 84107-7352 | 2006-12-21 |
| Find all providers in MURRAY | ||||
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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.