Amanda Sims Dominguez, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

019390 Issued in LA

Practice address

4974 Highway 3276 Ste B
Stonewall, LA 71078-9335

Phone

(318) 775-4371

Fax

(318) 775-7369

NPI assigned

Sep 11, 2014

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• NDD LLC

  dba North Desoto Drug

  • Community/Retail Pharmacy
  • Stonewall, LA
  • NPI 1255732012
  NPD Authorized official

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1023419785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4974 HIGHWAY 3276 STE B",
            "city": "STONEWALL",
            "state": "LA",
            "postal_code": "710789335",
            "telephone_number": "318-775-4371",
            "fax_number": "318-775-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4974 HIGHWAY 3276 STE B",
            "city": "STONEWALL",
            "state": "LA",
            "postal_code": "710789335",
            "telephone_number": "318-775-4371",
            "fax_number": "318-775-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "AMANDA",
        "middle_name": "SIMS",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "019390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawn Davis, FNP-C
• Larry Davis
• Katherine Deporter
• Desoto Physical Therapy, L.L.C.
• Janet Dodson
• Dalton R Dowden, PTA
• Wilma Draughn-Davis
• Gussie Dunkley
• Mary Durr
• Hope Edwards

• Pharmacist in Stonewall, LA
• Providers in Stonewall, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.