Dominique Elmore, DO

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

TP626 Issued in KY

Practice address

231 E Chestnut St
Louisville, KY 40202

Phone

(502) 629-6000

Fax

(502) 629-5991

NPI assigned

Apr 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316
  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Allergy/Immunology Physician
  • Louisville, KY
  • NPI 1972144590
  NPD
• University of Louisville Physicians, Inc.

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1386008381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-629-6000",
            "fax_number": "502-629-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-629-6000",
            "fax_number": "502-629-5991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite 3500",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013656",
            "country_code": "US",
            "telephone_number": "304-691-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "DOMINIQUE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "KY",
            "license": "TP626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelin H Elm, APRN
• Rifaat S Elmallakh, M.D.
• Elmcroft of Sherwood
• Stacey Charlotte Elmes, BA
• Ashleigh Brooke Elmore, APRN
• Geoffrey Elmore, CSW
• Jennifer Michelle Elmore, APRN
• Prachi Elmore, OTR
• Sidimohamed Elmoustapha
• Marwa Ali Mahgoub Elnazeir, M.D

• Pediatric Emergency Medicine (Pediatrics) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.