Individual provider Active NPI

Nana Mitchell-Dompreh

  • Family Nurse Practitioner
  • Elmont, NY
National Provider Identifier
1104157882
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344226 Issued in NY
Practice address
6 Albany St
Elmont, NY 11003-5011
Phone
(516) 284-7031
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 631632 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404072 NY
Family Nurse Practitioner 363LF0000X 344226 NY Primary

Addresses

Primary practice location

6 Albany St
Elmont, NY 11003-5011

Mailing address

6 Albany St
Elmont, NY 11003-5011
Phone (516) 284-7031

Other practice location 1

6 Albany St
Elmont, NY 11003-5011
Phone (516) 284-7031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
631632NYMDRegistered Nurse
344226NYMDFamily Nurse Practitioner
404072NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1104157882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ALBANY ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035011",
            "telephone_number": "516-284-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ALBANY ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035011",
            "telephone_number": "516-284-7031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Albany St",
            "address_purpose": "LOCATION",
            "city": "Elmont",
            "state": "NY",
            "postal_code": "110035011",
            "country_code": "US",
            "telephone_number": "516-284-7031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL-DOMPREH",
        "first_name": "NANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "631632",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404072",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.