Catherine Domanska Elliott, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP012517 Issued in PA

Practice address

105 Vineyard Way Ste 200
West Grove, PA 19390

Phone

(610) 444-7550

Fax

(610) 444-4656

NPI assigned

Nov 26, 2012

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

Other identifiers 1

Other names 1

• Catherine Alison Domanska Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: catherine.elliott.1@14261.direct.athenahealth.com

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.

• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1134458789
  Medicare reassignment NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1417812710
  NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1457758617
  NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1538681283
  NPD (past)

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1275877615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 WEST CYPRESS ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "19348",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VINEYARD WAY STE 200",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "19390",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CATHERINE",
        "middle_name": "DOMANSKA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP012517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102783059",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "DOMANSKA",
            "middle_name": "ALISON",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Betty Duzan, RBT
• Eckerd Corporation (Rite Aid Pharmacy 11156)
• Joseph F Eckman Jr., DM D
• Edward Jenny & Associates PC
• John Oliver Elkhoury, PA
• Zachary Emerson, DMD
• Emerus Pennsylvania Inpatient Providers PLLC
• Nicholas J Emge, PT
• Eric R. Miller, OD, PC (Miller Eye Care)
• Eric R. Miller, OD, PC (Miller Eye Care)

• Nurse Practitioner in West Grove, PA
• Providers in West Grove, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.