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

Kathleen Mary Dougherty

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1013621382

Kathleen Mary Dougherty is a Physician Assistant in Carmel, Indiana. Qualified in 2025, 1 year ago. Practices as a sole proprietor.

Years since qualifying
1
In the registry since
2023

Practice location Address checks out

1608 Cool Creek Dr
Carmel, IN 46033-2321
Phone: (317) 696-1099
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1013621382
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 10, 2023
Last updated in NPPESJanuary 10, 2023
Certification dateJanuary 10, 2023
Mailing address1608 Cool Creek Dr, Carmel, IN 46033-2321

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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