Rita Genoveva Dominguez Roman, CHW2

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

207Q00000X Issued in NV

Practice address

6285 Angora Peak LN
Las Vegas, NV 89115-1662

Phone

(954) 860-3216

NPI assigned

Sep 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Prevention Gambler Foundation Non Profit

  • Pastoral Counselor
  • North Las Vegas, NV
  • NPI 1144047713
  NPD Authorized official
• Prevention Gambler Foundation

  • Community Health Worker
  • Las Vegas, NV
  • NPI 1720836570
  NPD

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1396521241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 ANGORA PEAK LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891151662",
            "telephone_number": "954-860-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6285 ANGORA PEAK LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891151662",
            "telephone_number": "954-860-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ ROMAN",
        "first_name": "RITA",
        "middle_name": "GENOVEVA",
        "credential": "CHW2",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "NV",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI SPECIALTY-GROUP",
            "identifier": "193200000X",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Karen Dominguez Lopez
• Iraiz Dominguez Martinez
• Marlen Dominguez Moreno
• Nelson Dominguez Padilla
• Laura Gabriela Dominguez Perez
• Hannah Theresa Dominguez-Alvarez
• Emilio Dominguez-Barrera
• Martha Dominguez-de Rosas
• Marisol Dominguez-Delgado
• Meagan Rai Dominguez-Diaz, RN

• Community Health Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Health Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.