LISA MARIE DOUGHERTY (PT, DPT) – Physical Therapist, NPI 1164538773
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LISA MARIE DOUGHERTY (PT, DPT)
PO BOX 428
SNELLVILLE, GA 300780428
Phone: (770) 316-0601
Fax: (770) 978-6739
Type: Mailing
3315 Sugarloaf Pkwy
Suite 5
Lawrenceville, GA 300445497
Phone: (770) 316-0601
Fax: (770) 978-6739
Type: Location
511 Gordon Ave
Thomasville, GA 317926645
Phone: (229) 228-9019
Fax: (229) 228-6066
Type: Location
511 GORDON AVE
THOMASVILLE, GA 317926645
Phone: (229) 228-9019
Fax: (229) 228-6066
Type: Location
1200 CORPORATE DR STE 400
HOOVER, AL 352425424
Phone: (866) 518-0283
Fax: (423) 238-3628
Type: Mailing
660 LAKE JOY RD STE D
KATHLEEN, GA 310472382
Phone: (478) 313-5385
Type: Location
3315, Sugarloaf Parkway, Lawrenceville, Gwinnett County, Georgia, 30044, United States
SUITE 5
LAWRENCEVILLE, GA 300445497
Phone: (770) 316-0601
Fax: (770) 978-6739
Type: Location
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: 2008-02-20
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 |
|---|---|---|---|---|
| I20080220000580 | I | Physical Therapist In Private Practice | GA | 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 30078)
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