Domonique Vickers

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11005306 Issued in FL

Practice address

15418 Fire Rock PL
Ruskin, FL 33573-0196

Phone

(813) 498-9937

NPI assigned

Jul 20, 2021

Last updated

Jul 20, 2021By 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 FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitalcaring Group Home health agency, Tampa, FL, CCN 109761
• Etairos Health Inc Home health agency, Tampa, FL, CCN 109428

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Mana Health Partners PA

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1437925047
  Medicare reassignment Care Compare group NPD
• G. Alvarez, MD, P.a.

  • Family Medicine Physician
  • Brandon, FL
  • NPI 1619202314
  Medicare reassignment NPD
• Vital Health Concierge LLC

  • Primary Care Clinic/Center
  • Brandon, FL
  • NPI 1669245064
  Medicare reassignment NPD
• Vital Health Mobility Services LLC

  • Non-emergency Medical Transport (VAN)
  • Brandon, FL
  • NPI 1245084508
  NPD Authorized official

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

• Etairos Health, Inc

  dba Utopia Home Care

  • In Home Supportive Care Agency
  • Tampa, FL
  • NPI 1639495328

  Home health agency

  Care Compare affiliation
• Pinnacle Home Healthcare, Inc.

  dba VitalCaring Group

  • Home Health Agency
  • Winter Haven, FL
  • NPI 1427607555
  Care Compare affiliation
• Pinnacle Home Healthcare, Inc.

  dba VitalCaring Group

  • Home Health Agency
  • Tampa, FL
  • NPI 1467757641
  Care Compare affiliation

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1306419098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 FIRE ROCK PL",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335730196",
            "telephone_number": "813-498-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 FIRE ROCK PL",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335730196",
            "telephone_number": "813-498-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "DOMONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uplift Community Health Center LLC
• Eduardo Valdes, D.D.S
• Jaqueline Rose Vallina, LCSW
• James H Vann
• Cecilia Velasco
• Vision Specialty Associates, P.a. (Vision Specialty Assoc. P.a. #01)
• Vital Ride Services LLC
• Paulette Vital-Herne
• Maria Von Ellm-McKenna, PA-S
• Linda Vu, PA-C

• Family Nurse Practitioner in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.