DR. KEVIN GLEN DOHERTY (D.O.) – Emergency Medicine Physician, NPI 1518069236

DR. KEVIN GLEN DOHERTY (D.O.) is a healthcare provider. based in London, Ohio. specializing in EMERGENCY MEDICINE, FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 34.005332 (OH). The NPI Number for DR. KEVIN GLEN DOHERTY (D.O.) is 1518069236

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEVIN GLEN DOHERTY (D.O.)
NPI
1518069236
Phone
(740) 845-6735
Address
371 Lafayette St
Enumeration Date
2 September 2006
Last Update Date
31 May 2024

Doctor Profile

Medical School Name
OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6142934969
Graduation Year
1990 (36 years ago)
PAC ID
7113913401
Group Practice PAC ID
5799008082
Professional Enrollment ID
I20040422000431
Address ID
OH430812062WE6100XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,673 EMERGENCY MEDICINE in OH

Provider Addresses for DR. KEVIN GLEN DOHERTY (D.O.)

  • 371 Lafayette St

    London, OH 431409326

    Phone: (740) 845-6735

    Fax: (740) 845-6736

    Type: Location

  • 6511, Taggart Road, Liberty Township, Delaware County, Ohio, 43015, United States

    DELAWARE, OH 430158893

    Phone: (740) 548-6180

    Fax: (740) 548-1882

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-04-22

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040422000431IEmergency MedicineOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making7875$0
99284Emergency department visit with moderate level of medical decision making4948$0
View full utilization report →

Insurance plans in this area (ZIP 43140)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799008082View full group profile
NameSpecialtyState
-OH
Nurse PractitionerOH
Emergency Medicine, Pediatric MedicineOH
N E U R O L O G YOH
Orthopedic SurgeryTN
Nurse PractitionerOH
General SurgeryOH
Nurse PractitionerOH
Emergency MedicineME
Qualified AudiologistOH

Reviews

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Frequently asked questions

What is DR. KEVIN GLEN DOHERTY (D.O.)'s NPI number?
DR. KEVIN GLEN DOHERTY (D.O.)'s NPI is 1518069236 — the number used across U.S. healthcare to identify this provider.
Would DR. KEVIN GLEN DOHERTY (D.O.) appear as active to a payer?
You can treat DR. KEVIN GLEN DOHERTY (D.O.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. KEVIN GLEN DOHERTY (D.O.)?
DR. KEVIN GLEN DOHERTY (D.O.) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Ohio is DR. KEVIN GLEN DOHERTY (D.O.) registered?
Use London, Ohio as the headline location for DR. KEVIN GLEN DOHERTY (D.O.) here.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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