MS. KELLY ANN DOHERTY (FNP) – Family Nurse Practitioner, NPI 1760034862
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MS. KELLY ANN DOHERTY (FNP)
1121 N CENTER ST APT 207
ROYAL OAK, MI 480671283
Phone: (810) 845-2906
Type: Mailing
Beaumont Hospital - Dearborn, 18101, Oakwood Boulevard, Dearborn, Wayne County, Michigan, 48124, United States
DEARBORN, MI 481244089
Phone: (313) 593-7000
Type: Location
18000 W 9 MILE RD STE 200
SOUTHFIELD, MI 480754020
Phone: (248) 336-4000
Fax: (248) 336-9137
Type: Mailing
26300 WOODWARD AVE
ROYAL OAK, MI 480670917
Phone: (248) 336-4000
Fax: (248) 336-9137
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $553.
Total Amount is formed as General ($553) + Research ($0) + Ownership ($0) = $553.
Last reported payment date: 2024-04-23 • Largest payer in this snapshot: ABBVIE INC. ($325).
Total Amount
$553
General + Research + Ownership
Payments
29
Total payment records
General Amount
$553
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $325 |
| PFIZER INC. | $136 |
| Novo Nordisk Inc | $61 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $31 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-09-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190913000572 | I | Nurse Practitioner | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48067)
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Group practice members
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