Kevin S Dougherty (NPI# 1922412279, PAC ID# 0648572651) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1922412279 |
| PAC ID by PECOS | 0648572651 |
| Professional Enrollment ID | I20180727000887 |
| Full Name | Kevin S Dougherty |
| Organization Legal Name | GREEN BAY EMERGENCY PHYSICIANS, LLC |
| Address |
835 S Van Buren St Green Bay WI 54301-3526 |
| Phone Number | 4142906715 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 6901879303 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520097 | ST MARY'S HOSPITAL MEDICAL CENTER |
| 520075 | ST VINCENT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1726 Shawano Ave, Green Bay, WI 54303-3216 | 4142906715 | GREEN BAY EMERGENCY PHYSICIANS, LLC |
| 835 S Van Buren St, Green Bay, WI 54301-3526 | 4142906715 | GREEN BAY EMERGENCY PHYSICIANS, LLC |
| Organization Legal Name | GREEN BAY EMERGENCY PHYSICIANS, LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allen W Salmi | Emergency Medicine | Green Bay Emergency Physicians, LLC | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Christopher K Gerwing | Emergency Medicine | Green Bay Emergency Physicians, LLC | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Samuel J Leaf | Emergency Medicine | Green Bay Emergency Physicians, LLC | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| James R Gruenewald | Physician Assistant | Green Bay Emergency Physicians, LLC | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Michael R De Frank | Emergency Medicine | Green Bay Emergency Physicians, LLC | 1726 Shawano Ave, Green Bay, WI 54303-3216 |
| Timothy S Pavek | Emergency Medicine | Green Bay Emergency Physicians, LLC | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Angela C Wright | Emergency Medicine | Green Bay Emergency Physicians, LLC | 1726 Shawano Ave, Green Bay, WI 54303-3216 |
| Christopher Thompson | Emergency Medicine | Green Bay Emergency Physicians, LLC | 1726 Shawano Ave, Green Bay, WI 54303-3216 |
| Erin M Green | Emergency Medicine | Green Bay Emergency Physicians, LLC | 1726 Shawano Ave, Green Bay, WI 54303-3216 |
| Christopher B Kolar | Emergency Medicine | Green Bay Emergency Physicians, LLC | 1726 Shawano Ave, Green Bay, WI 54303-3216 |
| Street Address |
835 S VAN BUREN ST |
| City | GREEN BAY |
| State | WI |
| Zip | 54301-3526 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric T Dellamater | Nurse Practitioner | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Reginald E Julien | Anesthesiology | Green Bay Anesthesia Assoc. Sc | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Joseph D Chabot | Neurosurgery | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Charles L Levy | Neurosurgery | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Resa E Malloy | Physical Therapy | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Amanda Beinemann | Nurse Practitioner | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Charles F Dais Ii | Pathology | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Alison Jean Nohara | Diagnostic Radiology | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Christina L Smits | Physical Therapy | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Megan E Galske | Nurse Practitioner | St Vincent Hospital-hospital Sisters-third Order of St Francis | 835 S Van Buren St, Green Bay, WI 54301-3526 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy O Trupke | Physical Therapy | Andrews Physical Therapy Sc | 3208 E River Dr, Green Bay, WI 54301-1410 |
| Eliza M Andrews | Physical Therapy | Andrews Physical Therapy Sc | 3208 E River Dr, Green Bay, WI 54301-1410 |
| Tina Marie Baeten | Clinical Social Worker | Baeten Counseling and Consultation Team Sc | 2920 S Webster Ave B, Green Bay, WI 54301-1594 |
| Daniel D Lyons | Chiropractic | 2920 S Webster Ave, Suite 100, Green Bay, WI 54301-1594 | |
| Valorie A Helander | Clinical Social Worker | Baeten Counseling and Consultation Team Sc | 2920 S Webster Ave B, Green Bay, WI 54301-1594 |
| Jennifer A Sovey Fahey | Clinical Social Worker | Baeten Counseling and Consultation Team Sc | 2920 S Webster Ave B, Green Bay, WI 54301-1594 |
| Kayla Marie Franzluebbers | Chiropractic | Lyons Health, LLC | 2920 S Webster Ave, Green Bay, WI 54301-1594 |
| Ann Meier Carli | Optometry | Advanced Eyecare Center | 3237 Riverside Dr, Suite A, Green Bay, WI 54301-1643 |
| Glenn D Carli | Optometry | Advanced Eyecare Center | 3237 Riverside Dr, Suite A, Green Bay, WI 54301-1643 |
| Steven L Kagen | Allergy/immunology | 2333 Riverside Dr, Green Bay, WI 54301-1945 | |
| Find all physicians in zip 54301 | |||
| City | GREEN BAY |
| Zip Code | 54301 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | GREEN BAY + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Kevin S Dougherty.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.