Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kevin S. Dougherty, DO

Individual provider Emergency Medicine Physician · NPI 1922412279

Dr. Kevin S. Dougherty, DO is an Emergency Medicine in Cody, Wyoming. Graduated from Rocky Vista University College of Osteopathic Med in 2014, 12 years ago. Practices with Vituity-Wisconsin Em SC, a 57-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan, Wisconsin and Wyoming.

Years since qualifying
12
Trained at
Rocky Vista University College of Osteopathic Med
Licensed in
MI, WI, WY
In the registry since
2014
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

707 Sheridan Ave
Cody, WY 82414
Phone: (307) 578-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 835 S Van Buren St, Green Bay, WI 54301-3526 — (414) 290-6720
  • 1726 Shawano Ave, Green Bay, WI 54303-3216 — (414) 290-6720

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 14756A (WY)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 68949-21 (WI)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 5101021230 (MI)

Record details

NPI number1922412279
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 15, 2014
Last updated in NPPESJune 28, 2024
Certification dateApril 10, 2024
Mailing address707 Sheridan Ave, Cody, WY 82414-3409

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated 2014 (12 years in practice)
Group practice Vituity-Wisconsin Em Sc — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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