KELLY JILL DOUGHERTY MD
NPI 1376282764
Family Medicine in Festus, MO

Q: What is Kelly Dougherty's NPI number?

The NPI number for Kelly Dougherty is 1376282764. It was assigned to this individual provider in the NPPES registry on June 2, 2022.

Q: What is Kelly Dougherty's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Dougherty was last updated on October 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 02, 2022PECOS EnrolledAccepts Medicare Assignment

1275 N TRUMAN BLVD, FESTUS, MO 63028(844) 853-8937(636) 465-9512 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 26, 2025, Jul 5, 2022 (2 updates tracked since 2022).

On this page

About Kelly Jill Dougherty Md NPPES

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

KELLY JILL DOUGHERTY MD (NPI 1376282764) is an individual family medicine provider in Festus, Missouri, licensed in Missouri (2025001431) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Missouri, Columbia School Of Medicine (2018).

NPPES Registry Identity

NPI1376282764

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKELLY JILL DOUGHERTYCredential: MD

Location Address1275 N TRUMAN BLVDFestus, MO 63028-1176

Mailing Address1275 N Truman BlvdFestus, MO 63028-1176 · (636) 267-0600 · Fax (636) 465-9512

Phone(844) 853-8937

Fax(636) 465-9512

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2018

Enumeration DateJune 2, 2022

Last NPPES UpdateOctober 31, 20252 updates tracked since enumeration

NPPES CertifiedOctober 31, 2025

✔ NPI 1376282764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2025001431

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1275 N TRUMAN BLVD, Festus, MO 63028

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Jill Dougherty Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385023811

PECOS Enrollment IDI20250820002056

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 63028 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

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

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.

Other Providers at the Same Location NPPES 20

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

MR. RYAN EUGENE BUTLER RPH

Pharmacist