NPIMap

Individual provider Active NPI

Nau Deavin Domah, M.D.

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1558534263
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101245571 Issued in VA
Practice address
5855 Bremo Road
Suite 207
Richmond, VA 23226-1930
Phone
(804) 288-3079
Fax
(804) 282-6159
NPI assigned
Apr 2, 2008
Last updated
Feb 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301091486 MI
Internal Medicine Physician 207R00000X 0101245571 VA Primary

Addresses

Primary practice location

5855 Bremo Road
Suite 207
Richmond, VA 23226-1930

Mailing address

5855 Bremo Road
Suite 207
Richmond, VA 23226-1930
Phone (804) 288-3079

Other identifiers 3

IdentifierTypeStateIssuer
C05700OtherGROUP PTAN
C06778OtherVAGROUP PTAN
C06695OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000049 VA Practitioner - Internal Medicine 7012042542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7229 Forest Ave
Richmond, VA 23226-3765

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301091486MIMDInternal Medicine Physician
0101245571VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours - Memorial Regional Medical Center, Inc. CurrentSince Apr 1, 2014 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC CurrentSince Apr 1, 2014 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Current Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC Internal Medicine Past Accepting new patients
Bon Secours Memorial Regional Medical Center Inc Internal Medicine Past Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC Internal Medicine Past Accepting new patients
Primedoc of Richmond PC Internal Medicine Past Accepting new patients
Fredericksburg Hospitalist Group, P.C. Internal Medicine Past Accepting new patients

Locations

8200 Meadowbridge Rd
Ste 306
Mechanicsville, VA 23116
Phone (804) 764-1253

8220 Meadowbridge Rd
Ste 203
Mechanicsvlle, VA 23116
Phone (804) 226-2444

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

1500 N 28th St
Richmond, VA 23223
Phone (804) 225-1700

4630 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444

5855 Bremo Rd
Ste 207
Richmond, VA 23226
Phone (804) 237-1665

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

Interoperability endpoints

  • Direct secure messaging: ndomah1150727@direct.bsmhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 8

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1558534263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 BREMO ROAD",
            "address_2": "SUITE 207",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261930",
            "telephone_number": "804-288-3079",
            "fax_number": "804-282-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 BREMO ROAD",
            "address_2": "SUITE 207",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261930",
            "telephone_number": "804-288-3079",
            "fax_number": "804-282-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAH",
        "first_name": "NAU",
        "middle_name": "DEAVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091486",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101245571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C05700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.