SARA DOUGHERTY (NPI# 1821024480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821024480 |
| Entity Type | Individual |
| Full Name | SARA DOUGHERTY |
| Credential | NP |
| Practice Address |
7302 S Bingham Junction Blvd Midvale UT 84047-4804 |
| Practice Telephone | 8014425502 |
| Mailing Telephone | 8014425502 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 120828 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
10814308-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN002108 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100183120A | 05 | |
| MO | ANTHEM | 173861 | 01 |
| KS | 200000240A | 05 | |
| RR MEDICARE | 500014122 | 01 | |
| NV | SMA MEDICARE | V112696 | 01 |
| NV | SMA MEDICAID | 1821024480 | 01 |
| MO | 428623219 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 874 American Pacific Dr, Henderson, NV 890148800 | 7027774809 | 7027774822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649255332 | Sara Ellen Dougherty | Family Medicine | 7420 Greenhaven Drive, Suite 130, Sacramento, CA 95831 | 2005-12-14 |
| Street Address |
7302 S BINGHAM JUNCTION BLVD |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922060284 | Wayne Grant Crawford | Physician Assistant | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2006-04-03 |
| 1700259207 | Ihc Health Services Inc | Family Medicine | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2015-11-05 |
| 1932570116 | Kimberly Compagni | Pharmacist | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2015-10-13 |
| 1568756237 | Colleen Wright | Registered Nurse | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2011-05-31 |
| 1033414248 | Nicole Marie Johnson | Physician Assistant | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2011-01-19 |
| 1649502931 | Meghann R Hilgert | Physician Assistant | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2010-02-11 |
| 1760596365 | Nancy Louise Mecham | Nurse Practitioner | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2006-08-19 |
| 1104858083 | Jeffery L. Olson | Pharmacist | 7302 S Bingham Junction Blvd, Midvale, UT 84047-4804 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619486396 | Molina Healthcare of Utah | Nurse Practitioner | 7050 S Union Park Ave Ste 200, Midvale, UT 84047-4171 | 2017-09-25 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1871031708 | Joanna Ruth Kennedy | Nurse Practitioner | 602 E Fort Union Blvd, Midvale, UT 84047-2216 | 2017-02-12 |
| 1972936326 | Whitney Jean Mentaberry | Nurse Practitioner | 65 E Twin Peaks St, Midvale, UT 84047-1215 | 2013-08-20 |
| 1912207226 | Stacie R Pearce | Nurse Practitioner | 602 E 7200 S, Midvale, UT 84047-2216 | 2010-11-02 |
| 1578198966 | Alexandra Nicole Hecht | Nurse Practitioner | 7050 S Union Park Ave Ste 200, Midvale, UT 84047-4171 | 2020-03-06 |
| 1508498221 | Kira Sue Whaley | Nurse Practitioner | 7495 S State St, Midvale, UT 84047-2013 | 2020-02-11 |
| 1083276232 | Starlene Rose | Nurse Practitioner | 602 E Fort Union Blvd, Midvale, UT 84047-2216 | 2019-07-08 |
| 1912435421 | Kyle Olson | Nurse Practitioner | 7309 S 180 W, Midvale, UT 84047-1020 | 2017-05-28 |
| 1316491327 | Katherine Lynn O'brien | Nurse Practitioner | 8446 S Harrison St, Midvale, UT 84047-3501 | 2016-08-08 |
| Find all providers in MIDVALE | ||||
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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.