Active NPI
Dominic Montabon
- Registered Nurse
- Lewes, DE
National Provider Identifier
1518355593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- L1-0044237
- Practice address
- 17488 Slipper Shell Way
Unit 15
Lewes, DE 19958-6312 - Phone
- (856) 404-2699
- NPI assigned
- Dec 29, 2014
- Last updated
- Dec 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | L1-0044237 | DE | Primary |
Addresses
Primary practice location
17488 Slipper Shell Way
Unit 15
Lewes, DE 19958-6312
Mailing address
17488 Slipper Shell Way
Unit 15
Lewes, DE 19958-6312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0044237 | DE | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1518355593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17488 SLIPPER SHELL WAY",
"address_2": "UNIT 15",
"city": "LEWES",
"state": "DE",
"postal_code": "199586312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17488 SLIPPER SHELL WAY",
"address_2": "UNIT 15",
"city": "LEWES",
"state": "DE",
"postal_code": "199586312",
"telephone_number": "856-404-2699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTABON",
"first_name": "DOMINIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-29",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "DE",
"license": "L1-0044237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.