Individual provider Active NPI

Lisa Venable Dommert, RPH

  • Pharmacist
  • Alexandria, LA
National Provider Identifier
1235686502
Registry record updated Sep 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13719 Issued in LA
Practice address
1422 Macarthur Dr
Alexandria, LA 71301-4022
Phone
(318) 442-0512
Fax
(318) 443-4205
NPI assigned
Sep 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13719 LA Primary

Addresses

Primary practice location

1422 Macarthur Dr
Alexandria, LA 71301-4022

Mailing address

5705 Courtland PL
Alexandria, LA 71301-2665
Phone (318) 664-2852

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13719LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1235686502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 COURTLAND PL",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713012665",
            "telephone_number": "318-664-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 MACARTHUR DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713014022",
            "telephone_number": "318-442-0512",
            "fax_number": "318-443-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMMERT",
        "first_name": "LISA",
        "middle_name": "VENABLE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "13719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2016; 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.