Dominique K Bethea, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN281107 Issued in GA

Practice address

771 Old Norcross Rd Ste 200
Lawrenceville, GA 30046-4980

Phone

(770) 339-1387

Fax

(770) 962-7868

NPI assigned

Feb 20, 2019

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 GA

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

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400261

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.

• North Atlanta Endocrinology and Diabetes, PC

  • Specialist
  • Lawrenceville, GA
  • NPI 1386840379
  Medicare reassignment NPD
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1396201885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464980",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464980",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "DOMINIQUE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN281107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Raquel Bess, MD
• Best Care Home Hospice
• Bestcare Senior Home Inc.
• Matthew Bestic, LPC
• Esther Akawung Betanga
• Paulette M Bethel, MA LMFT, LPC
• Sierra Bethel
• Bethesda Medical Equipment & Supply Co, Inc
• Aiyanna Bethune
• Theresa Ann Betteker, PHARMD

• Family Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.