Individual provider Active NPI

Dominique Pearson, CRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1477256246
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11033165 Issued in FL
Practice address
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone
(813) 971-6000
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704371634 MI
Certified Registered Nurse Anesthetist 367500000X APRN11033165 FL Primary

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613-4613

Mailing address

1A Burton Hills Blvd
Nashville, TN 37215-6100

Other practice location 1

1355 Bogue St
East Lansing, MI 48824-6207
Phone (517) 355-1855

Other practice location 2

7171 N Dale Mabry Hwy
Tampa, FL 33614-2665
Phone (813) 932-2222

Other practice location 3

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710005188 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789129073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Michigan State University College of Human Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Florida Anesthesiologists LLCGroup PAC ID 3173711017, 315 clinicians

Practice addresses (Care Compare)

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (954) 393-5000

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (954) 939-5000

900 Carillon Pkwy
Suite 205
Saint Petersburg, FL 33716-1108
Phone (954) 939-5000

Hospital & facility affiliations

  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704371634MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC CurrentSince Jun 5, 2024 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2024 Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1477256246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-971-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 Bogue St",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488246207",
            "country_code": "US",
            "telephone_number": "517-355-1855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7171 N Dale Mabry Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336142665",
            "country_code": "US",
            "telephone_number": "813-932-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449207",
            "country_code": "US",
            "telephone_number": "813-929-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "DOMINIQUE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704371634",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11033165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.