Nicole Ann Dominique-Branley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

340450 Issued in LA

Practice address

604 N Acadia Rd Ste 100
Thibodaux, LA 70301-4897

Phone

(985) 447-9045

Fax

(985) 447-3349

NPI assigned

Apr 6, 2021

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

Other names 1

• Nicole Ann Dominique Former name

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ndominiquebranley74920@valleychildrens-prd.direct-ci.com

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.

• Thibodaux Regional Network Development Corporation

  • Anesthesiology Physician
  • Thibodaux, LA
  • NPI 1285658310
  Medicare reassignment NPD
• Thibodaux Regional Network Development Corporation

  • Diagnostic Radiology Physician
  • Thibodaux, LA
  • NPI 1467427336
  NPD
• Thibodaux Regional Network Development Corporation

  • Clinical Cardiac Electrophysiology Physician
  • Thibodaux, LA
  • NPI 1770435851
  NPD
• Thibodaux Regional Health System Inc

  • General Acute Care Hospital
  • Thibodaux, LA
  • NPI 1902465065
  NPD (past)

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1104405216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 100",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "985-447-9045",
            "fax_number": "985-447-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIQUE-BRANLEY",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "340450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DOMINIQUE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooke Kathleen Doalson, M.ED, LAT, ATC
• Gregory Dobard, M.D.
• Doctors Flynn Manceaux Arcement Pizzolato of Thibodaux a Professional
• Debra Gail Domangue, RPH
• Karley Elizabeth Domingue, APRN
• Brea Angele Dominique, RD, LDN
• Stacey L Donnelly
• Thomas R Donner, MD
• Alyce Doucet, LPN
• Annabella I Dove, BA

• Pediatrics Physician in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.