DR. MARK CHRYSOSTOM DOUGHERTY (NPI# 1265925234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265925234 |
| Entity Type | Individual |
| Full Name | DR. MARK CHRYSOSTOM DOUGHERTY |
| Credential | MD |
| Practice Address |
200 Hawkins Dr Dept Of Iowa City IA 52242-1009 |
| Practice Telephone | 3193562237 |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2018-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | R-11336 | IA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649324021 | Mark G Dougherty | Dentist | 645 Penn Ave, West Reading, PA 19611 | 2007-01-22 |
| 1518053768 | Mark Dougherty | Dentist | 17300 Yorba Linda Blvd, Suite H, Yorba Linda, CA 92886-3810 | 2006-10-05 |
| 1427016542 | Mark H Dougherty | Anesthesiology | 690 Canton St, Suite 325, Westwood, MA 02090-2321 | 2006-05-01 |
| 1326049628 | Mark J Dougherty | Internal Medicine | 1720 Nicholasville Rd, Suite 602, Lexington, KY 40503-1475 | 2005-08-09 |
| Street Address |
200 HAWKINS DR DEPT OF |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52242-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598961187 | Shiv Patel | Radiology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242 | 2007-06-21 |
| 1649897687 | Beatriz Dinh | Specialist | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-25 |
| 1417573882 | Harris Syed | Family Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-22 |
| 1124644828 | Taylor James Den Hartog | Orthopaedic Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-19 |
| 1366068942 | Melissa Toeller-desimone | Anesthesiology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-19 |
| 1124644786 | Nathan Kemper | Otolaryngology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-19 |
| 1467078311 | Gregory Kirkpatrick | Internal Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-17 |
| 1407472327 | Stephen Stone | Internal Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-17 |
| 1235755026 | Melanie Claire Morris | Pediatrics | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-17 |
| 1720603608 | John Brennan Hunter Whitacre | Psychiatry & Neurology | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738679 | Shannon Louise Miers | Physical Therapist | Ui Sports Medicine (iosmr), 2701 Prairie Meadow Drive, Iowa City, IA 52242 | 2020-04-14 |
| 1821624230 | Victoria Troesch | Student in an Organized Health Care Education/Training Program | 375 Newton Rd, Iowa City, IA 52242 | 2020-03-17 |
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1407330483 | Kristin L Heider | Psychologist | 616 E Bloomington Street, Iowa City, IA 52242 | 2018-09-17 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1528544780 | Abigail Lynne Schiltz | Physician Assistant | 200 Hawkins Dr 01290a Pfp, Iowa City, IA 52242 | 2018-07-11 |
| 1710474259 | Bashar H. H. Abuqayas | Hospitalist | 200 Hawkins Dr, Se 636 Gh, Uihc-internal Medicine, Iowa City, IA 52242 | 2018-04-19 |
| 1023547395 | Tyler Quist | Internal Medicine | 200 Hawkins Dr Dept of Ophthalmology, Iowa City, IA 52242 | 2017-06-08 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1649667734 | Jennie Sertterh | Specialist/Technologist | 1 Elliot Drive, S181 Carver Hawkeye Arena, Iowa City, IA 52242 | 2015-04-16 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447874425 | Anthony John Marincovich | Neurological Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2020-06-04 |
| 1497378038 | Tyson Sean Matern | Neurological Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-05-18 |
| 1093376634 | Timothy Robert Woodiwiss | Neurological Surgery | 200 Hawkins Dr, Department of Neurosurgery, Iowa City, IA 52242 | 2019-06-25 |
| 1083272348 | Joshua Bauer | Neurological Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2019-06-03 |
| 1134613466 | David Thomas Christianson | Neurological Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2018-06-20 |
| 1952892549 | Michael Elias Kritikos | Neurological Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2018-05-20 |
| 1730604034 | Satoshi Yamaguchi | Neurological Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2017-08-08 |
| 1457874745 | Colin Gold | Neurological Surgery | 200 Hawkins Dr., Iowa City, IA 52242 | 2017-07-19 |
| 1144757162 | Brian Park | Neurological Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2017-05-22 |
| 1952840092 | Carlos Manuel Alvarez | Neurological Surgery | 200 Hawkins Dr Dept Of, Iowa City, IA 52242 | 2017-02-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.