Organization Active NPI

Domi Chiropractic & Wellness Center

  • Chiropractor
  • Escondido, CA
National Provider Identifier
1114503562
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DOMI CHIROPRACTIC & WELLNESS CENTER
Practice address
336 S Broadway
Escondido, CA 92025-4207
Phone
(760) 291-1900
NPI assigned
Mar 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Lauren Knox
Title
Office Manager
Phone
(717) 319-7993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

336 S Broadway
Escondido, CA 92025-4207

Mailing address

336 S Broadway
Escondido, CA 92025-4207
Phone (760) 291-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dr.lizd@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221027003156 CA Part B Supplier - Clinic/Group Practice 3274900626 Receives reassigned benefits from 1 practitioner
Practice locations: Escondido, CA

National Provider Directory

National Provider Directory

Locations

336 S Broadway
Escondido, CA 92025
Phone (717) 319-7993

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1114503562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 S BROADWAY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254207",
            "telephone_number": "760-291-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 S BROADWAY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254207",
            "telephone_number": "760-291-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMI CHIROPRACTIC & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "717-319-7993"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dr.lizd@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "336 S Broadway",
            "city": "Escondido",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920254207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.