Individual provider Active NPI

Amy Michel D'Domenicus, RN

  • Registered Nurse
  • Columbia, MD
National Provider Identifier
1558736637
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R170075 Issued in MD
Practice address
7055 Samuel Morse Dr
Columbia, MD 21046-3439
Phone
(410) 910-6700
NPI assigned
Dec 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R170075 MD Primary

Addresses

Primary practice location

7055 Samuel Morse Dr
Columbia, MD 21046-3439

Mailing address

7055 Samuel Morse Dr
Columbia, MD 21046-3439
Phone (410) 910-6700

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R170075MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1558736637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7055 SAMUEL MORSE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463439",
            "telephone_number": "410-910-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7055 SAMUEL MORSE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463439",
            "telephone_number": "410-910-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'DOMENICUS",
        "first_name": "AMY",
        "middle_name": "MICHEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R170075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.