SALLY DOUGHTY
NPI 1295316057
Nurse Practitioner - Family in Evansville, IN

Q: What is Sally Doughty's NPI number?

The NPI number for Sally Doughty is 1295316057. It was assigned to this individual provider in the NPPES registry on April 14, 2021.

Q: What is Sally Doughty's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Sally Doughty was last updated on April 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 April 14, 2021PECOS Enrolled

86.75/100

CMS Quality Rating

4480 1ST AVE, EVANSVILLE, IN 47710(812) 425-1525 Get Directions Write a Review

NPPES record last updated: April 14, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sally Doughty NPPES

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

SALLY DOUGHTY (NPI 1295316057) is an individual family provider in Evansville, Indiana, licensed in Indiana (71011051A) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295316057

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSALLY DOUGHTY

Location Address4480 1ST AVEEvansville, IN 47710-3622

Mailing Address4480 1st AveEvansville, IN 47710-3622 · (866) 389-2727

Phone(812) 425-1525

Sole ProprietorNo

Enumeration DateApril 14, 2021

NPPES CertifiedApril 14, 2021

✔ NPI 1295316057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in IN · 71011051A

4480 1ST AVE, Evansville, IN 47710

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sally Doughty 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47710 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.47

Improvement Activities

Cost

89.8

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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALEB D SCHMITT FNP

Nurse Practitioner (Family)