Individual provider Active NPI

Nancy Dominick-Gravel, D.C.,

  • Chiropractor
  • Mandeville, LA
National Provider Identifier
1124126560
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
591 Issued in LA
Practice address
2201 11TH St
Suite 1
Mandeville, LA 70471-1848
Phone
(985) 626-4422
Fax
(985) 626-1190
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 591 LA Primary

Addresses

Primary practice location

2201 11TH St
Suite 1
Mandeville, LA 70471-1848

Mailing address

2201 11TH St
Suite 1
Mandeville, LA 70471-1848
Phone (985) 626-4422

Other names 1

  • Dr. Nancy Dominick Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080116000661 LA Practitioner - Chiropractic 6608957568 Practice locations: Mandeville, LA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2201 11TH St
Suite 1
Mandeville, LA 70471-1830
Phone (985) 626-4422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy J. Dominick, LTD Chiropractor PastSince Sep 2, 2016 Accepting new patients

Networks

  • LA PPO C-SNP

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124126560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 11TH ST",
            "address_2": "SUITE 1",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711848",
            "telephone_number": "985-626-4422",
            "fax_number": "985-626-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 11TH ST",
            "address_2": "SUITE 1",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711848",
            "telephone_number": "985-626-4422",
            "fax_number": "985-626-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK-GRAVEL",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "D.C.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "DOMINICK",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.