Dorothy McKenzie Womack, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1125421 Issued in TX

Practice address

3535 N Fourth St Ste 400
Longview, TX 75605-0038

Phone

(903) 757-3881

Fax

(903) 757-5948

NPI assigned

Jun 9, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Texas Tech University Health Science Center School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wallis Dermatology Associates PLLCGroup PAC ID 0749440188, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.54 of 100Reported as group

Quality

68.5

Promoting interoperability

92

Improvement activities

40

Cost

53.31

Merit-based Incentive Payment System (MIPS)

Final score

49.94 of 100Reported as group

Quality

9.82

Promoting interoperability

100

Improvement activities

0

Cost

73.31

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wallis Dermatology Associates PLLC

  • Dermatology Physician
  • Longview, TX
  • NPI 1396945234
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1003590282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-757-3881",
            "fax_number": "903-757-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-757-3881",
            "fax_number": "903-757-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "DOROTHY",
        "middle_name": "MCKENZIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1125421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Wisdom, LCDC
• Betty Jane Witherspoon, LMSW
• David R Witt, MD
• Holly Witt
• Mark A Witt, DPM
• Stephen Womack, MD
• Aiya Christina Wommack, RN
• Tonya Wong
• Wood OB GYN Associates
• Arlis Gale Wood, PH.D.

• Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.