Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MR. PATRICK KELLY DOUGHERTY
Active
Individual
MR. PATRICK KELLY DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06557
TX
363AM0700X
Medical Physician Assistant
PA06557
TX
363AS0400X
Surgical Physician Assistant
002400
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002400
PA LICENSE
CT
01
—
PA06557
PA LICENSE
TX
Enumeration date
01/18/2010
Last updated
09/07/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up