MRS. SHAYNE KING DOUGHERTY CRNP
NPI 1154358752
Nurse Practitioner - Pediatrics in Havertown, PA

Q: What is Shayne Dougherty's NPI number?

The NPI number for Shayne Dougherty is 1154358752. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Q: What is Shayne Dougherty's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Shayne Dougherty was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 27, 2006PECOS Enrolled

32 GREENVIEW LN, HAVERTOWN, PA 19083(610) 924-9763 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Mrs. Shayne King Dougherty Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHAYNE KING DOUGHERTY CRNP (NPI 1154358752) is an individual pediatrics provider in Havertown, Pennsylvania, licensed in Pennsylvania (SP007565) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154358752

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMRS. SHAYNE KING DOUGHERTYCredential: CRNP

Location Address32 GREENVIEW LNHavertown, PA 19083-4313

Mailing Address3400 Civic Center Blvd.Philadelphia, PA 19104-4399 · (267) 426-5112 · Fax (215) 590-3053

Phone(610) 924-9763

Sole ProprietorNo

Enumeration DateJune 27, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1154358752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in PA · SP007565

32 GREENVIEW LN, Havertown, PA 19083

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shayne King Dougherty Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shayne Dougherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Children's Health Care Associates

5.9 mi

Pediatrics

34TH & CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
Philadelphia, PA 19104

Reassigned Medicare billing, Pennsylvania enrollment
Medicare enrollment name: Childrens Health Care Associates Inc
1,225 clinicians in this Medicare group

NPI 1619062668 (215) 590-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19083 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shayne Dougherty's NPI number?

The NPI number for Shayne Dougherty is 1154358752. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Where is Shayne Dougherty located?

Shayne Dougherty practices at 32 Greenview Ln, Havertown, PA 19083. The listed phone number is (610) 924-9763.

What is Shayne Dougherty's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Shayne Dougherty enrolled in Medicare?

Yes. Shayne Dougherty is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shayne Dougherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shayne Dougherty reassigns Medicare benefits to Children's Health Care Associates (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shayne Dougherty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shayne Dougherty was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.