Andrea Dominick

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009682 Issued in NC

Practice address

409 Blandwood Ave
Greensboro, NC 27401-2705

Phone

(336) 285-7616

NPI assigned

Oct 28, 2015

Last updated

Oct 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Telos Health Systems NC PLLC

  • Internal Medicine Physician
  • Mooresville, NC
  • NPI 1265064414
  NPD

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1407228521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 LEO DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053332",
            "telephone_number": "336-253-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BLANDWOOD AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012705",
            "telephone_number": "336-285-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stesha Adai Doku, MD
• William E Dolan, O.D.
• Scott Dollar
• Autumn S Domingez, PHARM D, RPH
• Kerusso Pooley Dominguez, DDS
• Dominion Diagnostics LLC
• Dominion Radiology LLC
• Donald J Digby MD PA (Digby Eyewear)
• Lareese Donaldson
• Natalie Meredith Donati Garmon, ACNPC-AG

• Clinical Social Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.