Individual provider Active NPI

Dominique Mitchell

  • Transportation Network Company
  • Milwaukee, WI
National Provider Identifier
1184395287
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation Network CompanyTaxonomy code 342000000X
Practice address
4731 W Leon Ter
Milwaukee, WI 53216-2332
Phone
(414) 241-0945
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Network Company 342000000X Primary

Addresses

Primary practice location

4731 W Leon Ter
Milwaukee, WI 53216-2332

Mailing address

4731 W Leon Ter
Milwaukee, WI 53216-2332
Phone (414) 241-0945

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NPI

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

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1184395287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 W LEON TER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162332",
            "telephone_number": "414-241-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 W LEON TER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162332",
            "telephone_number": "414-241-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NPI",
            "affiliation": "N",
            "address_1": "4731 W Leon Ter",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532162332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.