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MR. MICHAEL DEVIN DOUGHERTY ARNP
NPI 1972129476
Nurse Practitioner - Family in Apo, AE

Active since June 19, 2020PECOS Enrolled
UNIT 33100 BOX LANDSTUHL, APO, AE 09180(314) 590-5056 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 17, 2024, Jun 19, 2020 (2 updates tracked since 2020).

About Mr. Michael Devin Dougherty Arnp NPPES

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

MR. MICHAEL DEVIN DOUGHERTY ARNP (NPI 1972129476) is an individual family provider in Apo, AE, licensed in Florida (11007658) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972129476
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. MICHAEL DEVIN DOUGHERTYCredential: ARNP
Location AddressUNIT 33100 BOX LANDSTUHLApo, AE 09180-3100
Mailing AddressUnit 33100 Box LandstuhlApo, AE 09180-3100
Phone(314) 590-5056
Sole ProprietorNo
Enumeration DateJune 19, 2020
Last NPPES UpdateJuly 17, 20242 updates tracked since enumeration
NPPES CertifiedJuly 17, 2024
✔ NPI 1972129476 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 FL · 11007658

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Michael Devin Dougherty Arnp 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 Michael Dougherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Patients First Lake Ella Medical Center P A
Family Medicine
1690 N MONROE ST
Tallahassee, FL 32303
  • Reassigned Medicare billing, Florida enrollment
  • 52 clinicians in this Medicare group
NPI 1164524039 (850) 385-2222

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

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.

DR. SARAH JANET RABIE M.D.
Obstetrics & Gynecology
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-4697
DR. RAYMOND LI-MING PHUA PT
Physical Therapist (Orthopedic)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-4913
TRACY COX LICSW
Social Worker (Clinical)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-6310
DR. MICHAEL JORGE PHD
Psychologist (Counseling)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-7920
SAMANTHA OBRIEN
Nurse Practitioner (Family)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-4913
ERIC ALLEN LEE II MD
Psychiatry & Neurology (Psychiatry)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 636-9585
DR. CARMEN GADDINI VAVRA DO
Pediatrics
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-5762
KATHLEEN NICOL LICSW
Counselor (Mental Health)
UNIT 33100 BOX LANDSTUHL
APO, AE 09180
(314) 590-4058

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 Michael Dougherty's NPI number?

The NPI number for Michael Dougherty is 1972129476. It was assigned to this individual provider in the NPPES registry on June 19, 2020.

Where is Michael Dougherty located?

Michael Dougherty practices at Unit 33100 Box Landstuhl, Apo, AE 09180. The listed phone number is (314) 590-5056.

What is Michael Dougherty's specialty?

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

Is Michael Dougherty enrolled in Medicare?

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

Which organization bills Medicare for Michael Dougherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Dougherty reassigns Medicare benefits to Patients First Lake Ella Medical Center P A (Tallahassee, FL). 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 Michael 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 Michael Dougherty was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.