NPIMap

Organization Active NPI

Dominion Health Inc.

  • Clinic/Center
  • Cheyenne, WY
National Provider Identifier
1508162785
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DOMINION HEALTH INC.
Practice address
109 517TH St
Suite 25
Cheyenne, WY 82001
Phone
(718) 436-0037
Fax
(718) 853-3269
NPI assigned
Feb 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Authorized official

Name
Dr. Esther Phyllis Pellmutter
Title
MD, Ceo
Phone
(718) 436-0037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

109 517TH St
Suite 25
Cheyenne, WY 82001

Mailing address

5001A 15TH Ave.
Brooklyn, NY 11219
Phone (718) 436-0037

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1508162785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001A 15TH AVE.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-436-0037",
            "fax_number": "718-853-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 517TH ST",
            "address_2": "SUITE 25",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "telephone_number": "718-436-0037",
            "fax_number": "718-853-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "PELLMUTTER",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_middle_name": "PHYLLIS",
        "authorized_official_title_or_position": "MD, CEO",
        "authorized_official_telephone_number": "718-436-0037",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.