Active NPI
Dominique Bellegarde, CLC,CLE,CCHW
- Doula
- Boston, MA
National Provider Identifier
1366177602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- Practice address
- 306 Washington St Apt 3
Boston, MA 02121-3971 - Phone
- (617) 329-1277
- NPI assigned
- Jul 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | |||
| Midwife | 176B00000X | |||
| Doula | 374J00000X | MA | Primary | |
| Community Health Worker | 172V00000X | CHW00280 | MA |
Addresses
Primary practice location
306 Washington St Apt 3
Boston, MA 02121-3971
Mailing address
306 Washington St Apt 3
Dorchester, MA 02121-3971
Phone (617) 892-3634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33659 | Other | MA | LACTATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHW00280 | MA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1366177602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 WASHINGTON ST APT 3",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021213971",
"telephone_number": "617-892-3634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 WASHINGTON ST APT 3",
"city": "BOSTON",
"state": "MA",
"postal_code": "021213971",
"telephone_number": "617-329-1277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLEGARDE",
"first_name": "DOMINIQUE",
"name_prefix": "Ms.",
"credential": "CLC,CLE,CCHW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-20",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": null,
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": null,
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "MA",
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MA",
"license": "CHW00280",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LACTATION",
"identifier": "33659",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.