Peace of Mind Amelia, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PEACE OF MIND AMELIA, LLC

Practice address

910 S 8TH St Ste 205
Fernandina Beach, FL 32034-3771

Phone

(904) 206-0700

Fax

(585) 207-6169

NPI assigned

Jan 30, 2025

Organization subpart

No

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

Authorized official

Name

Ms. Theresa Domagola, NPNPI 1184676322

Title

President

Phone

(904) 206-0700

Specialties & licenses 1

Addresses

Other names 1

• Theresa Domagola, PMHNP-BC Other name

Locations

Practitioners 1

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

• Theresa M Domagola, ACNP-BC, PMHNP-BC

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1184676322
  NPD Authorized official

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1275346553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 TURTLE SHORES DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320346643",
            "telephone_number": "904-206-0700",
            "fax_number": "585-207-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S 8TH ST STE 205",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343771",
            "telephone_number": "904-206-0700",
            "fax_number": "585-207-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND AMELIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "DOMAGOLA",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-206-0700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Domagola, PMHNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Parsons, RT (R)(MR)
• Vivian F Paskowski, APRN
• Meghna Patel, P.T.A.
• Whitney Allison Patrickson, PT
• Kristy Pavelock
• Deborah K Peacock, APRN
• Pediatrix Medical Group Florida Inc
• Joy Susan Pendergrass, FNP,BC
• Donald Penny
• Joanne Perez-Vergara, RDN. LD/N

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.