DR. JACOB RANDALL DOUGHERTY (NPI# 1326577859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326577859 |
| Entity Type | Individual |
| Full Name | DR. JACOB RANDALL DOUGHERTY |
| Credential | DPM |
| Practice Address |
10701 East Blvd Cleveland OH 44106-1702 |
| Mailing Address |
730 Goodlette Rd N Ste 102 Naples FL 34102-5617 |
| Practice Telephone | (216) 791-3800 |
| Practice Fax Number | 2164213038 |
| Mailing Telephone | 2394303668 |
| Mailing Fax Number | 2396929436 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2020-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO4179 | FL | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497303416 | Jacob A Dougherty | Case Manager/Care Coordinator | 3055 Wilshire Blvd Ste 300, Los Angeles, CA 90010-1147 | 2019-09-03 |
| 1457697930 | Jacob Andrew Dougherty | Counselor | 1913 Meade St, North Bend, OR 97459-3432 | 2013-01-02 |
| Street Address |
10701 EAST BLVD |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44106-1702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942208939 | Beverly A Wisdom | Physician Assistant | 10701 East Blvd, Suite 1b 236, Cleveland, OH 44106-1702 | 2005-07-13 |
| 1013517366 | Michael Nielsen | Recreational Therapist Assistant | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-10-27 |
| 1063010692 | Hailey L Thomas | Dietitian, Registered | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-10-15 |
| 1588262406 | Kinxian Thach | Registered Nurse | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-10-13 |
| 1942817572 | Robin Eminger | Nurse Practitioner | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-09-28 |
| 1396352076 | Brittany B Boykin | Respiratory Therapist, Registered | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-09-28 |
| 1669086955 | Colleen A Gepperth | Nurse Practitioner | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-09-03 |
| 1588277966 | Tarah Midy | Psychologist | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-08-26 |
| 1710590062 | Colleen Licursi | Social Worker | 10701 East Blvd, Cleveland, OH 44106-1702 | 2020-08-26 |
| 1952913873 | Shivali Dyal Singh | Pharmacist | 10701 East Blvd, Cleveland, OH 44106 | 2020-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347706 | Adeeb Oweidat | Anesthesiology | 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 | 2020-08-18 |
| 1104434240 | Bradly Miner | Student in an Organized Health Care Education/Training Program | Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 | 2020-07-15 |
| 1306466974 | Ho Jun Lee | Student in an Organized Health Care Education/Training Program | 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 | 2020-04-23 |
| 1528687837 | Shaleeka Cornelius | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2020-04-16 |
| 1598393175 | Mikdat Ulas | Student in an Organized Health Care Education/Training Program | 111000 Euclid Avenue, Cleveland, OH 44106 | 2020-03-30 |
| 1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
| 1881246783 | Oziel Valdez Sanchez | Student in an Organized Health Care Education/Training Program | 11900 Euclid Ave, Cleveland, OH 44106 | 2019-07-10 |
| 1487216842 | Betina Griens Porto | Dentist | 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 | 2019-07-05 |
| 1407417140 | Rebecca Petts | Dentist | 9601 Chester Ave, Cleveland, OH 44106 | 2019-06-24 |
| 1023677259 | Moeen Al Weshah | Student in an Organized Health Care Education/Training Program | 9601 Chester Ave # 239j3, Cleveland, OH 44106 | 2019-06-11 |
| Find all providers in zip 44106 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629408703 | John N. Gernert | Podiatrist | 105 Keith St, Cleveland, TN 37311-1704 | 2013-11-26 |
| 1649315789 | My Foot Doctor Pllc | Podiatrist | 106 Stuart Rd Ne, Cleveland, TN 37312-4803 | 2007-02-20 |
| 1821190307 | Jonathon Lee Strickler | Podiatrist | 3000 Westside Dr Nw, Cleveland, TN 37312-3542 | 2006-09-03 |
| 1588649826 | Alan L. Wittenberg | Podiatrist | 17929 Euclid Ave, Cleveland, OH 44112-1221 | 2005-12-09 |
| 1407852767 | Donald Kushner | Podiatrist | 10701 E Blvd, Cleveland Dept of Veterans Affairs Medical Center, Cleveland, OH 44106 | 2005-06-22 |
| 1720081078 | Barry Schulman | Podiatrist | 52 Mouse Creek Rd Nw, Cleveland, TN 37312-4839 | 2005-05-31 |
| 1659989275 | Jeremy Perse, Dpm, LLC | Podiatrist | 2351 E 22nd St, Cleveland, OH 44115-3111 | 2020-07-20 |
| 1891357612 | Mitchell Bloomquist | Podiatrist | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2019-07-01 |
| 1295394294 | Jonathan Matthew Moss | Podiatrist | 2351 E 22nd St, Cleveland, OH 44115-3111 | 2019-06-12 |
| 1376109215 | Rizaldy Garcia | Podiatrist | Cleveland Clinic, 9500 Euclid Avenue/na23, Cleveland, OH 44195 | 2019-05-16 |
| Find all providers in CLEVELAND | ||||
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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.