Active NPI
Martha O Dommisse, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Richmond, VA
National Provider Identifier
1083773006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 0101240512
- Practice address
- 1201 Broad Rock Blvd
Richmond, VA 23249-0001 - Phone
- (804) 675-6746
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 0101240512 | VA | Primary |
Addresses
Primary practice location
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Mailing address
772 Colony Oak LN
Midlothian, VA 23114-4684
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170223000394 | VA | Order and Referring Only - Family Practice | 2769536028 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298332800000",
"number": "1083773006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "772 COLONY OAK LN",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231144684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 BROAD ROCK BLVD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232490001",
"telephone_number": "804-675-6746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMMISSE",
"first_name": "MARTHA",
"middle_name": "O",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2011-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "VA",
"license": "0101240512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.