Kathy L Domiano, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

154500 Issued in MO

Practice address

504 NW 10TH Ave
Ava, MO 65608

Phone

(417) 683-4831

Fax

(417) 683-1602

NPI assigned

Sep 6, 2007

Last updated

Mar 6, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas County Public Health Services Group, Inc.Group PAC ID 3072423052, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cox Medical Centers Hospital, Springfield, MO, CCN 260040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Douglas County Public Health Services Group, Inc.

  dba Missouri Ozarks Community Health

  • Federally Qualified Health Center (FQHC)
  • Mansfield, MO
  • NPI 1912904004
  Medicare reassignment Care Compare group NPD
• Douglas County Public Health Services Group, Inc.

  dba Missouri Ozarks Community Health

  • Family Medicine Physician
  • Licking, MO
  • NPI 1629639109
  NPD
• Douglas County Public Health Services Group, Inc.

  dba Missouri Ozarks Community Health

  • Federally Qualified Health Center (FQHC)
  • Gainesville, MO
  • NPI 1598762593
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lester E Cox Medical Centers

  dba Cox Medical Centers

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1093740128
  Care Compare affiliation
• Lester E Cox Medical Centers

  dba CoxHealth

  • Land Ambulance
  • Springfield, MO
  • NPI 1114044823

  Hospital

  Care Compare affiliation
• Lester E. Cox Medical Centers

  dba Cox Air Care

  • Air Ambulance
  • Springfield, MO
  • NPI 1578680286

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1265627970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 NW 10TH AVE",
            "address_2": "PO BOX 1359",
            "city": "AVA",
            "state": "MO",
            "postal_code": "65608",
            "telephone_number": "417-683-4831",
            "fax_number": "417-683-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 NW 10TH AVE",
            "city": "AVA",
            "state": "MO",
            "postal_code": "65608",
            "telephone_number": "417-683-4831",
            "fax_number": "417-683-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMIANO",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "154500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danica Lael Cody
• Shari Ranee Cook, FNP
• Jerriann Coxson, CFNP
• Deaconess Long Term Care of Ohio, Inc. (Ava Place)
• Denney Chiropractic
• Douglas County Health Department
• Douglas County Public Health Services Group, Inc. (MOCH Pharmacy)
• Douglas County Public Health Services Group, Inc.
• Douglas County Public Health Services Group, Inc. (Missouri Ozarks Community Health)
• Douglas County Public Health Services Group, Inc. (Missouri Ozarks Community Health)

• Primary Care Nurse Practitioner in Ava, MO
• Providers in Ava, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.
• 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.