Individual provider Active NPI

Brittany Ann Domier, D.C.

  • Chiropractor
  • Prior Lake, MN
National Provider Identifier
1609112622
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5710 Issued in MN
Practice address
16180 Hastings Ave SE Ste 202
Prior Lake, MN 55372-9228
Phone
(952) 999-1353
NPI assigned
Dec 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5710 MN Primary

Addresses

Primary practice location

16180 Hastings Ave SE Ste 202
Prior Lake, MN 55372-9228

Mailing address

19057 Oak Grove Ave
Prior Lake, MN 55372-3483
Phone (612) 207-8727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000051 MN Practitioner - Chiropractic 7214173608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16180 Hastings Ave SE
Suite 202
Prior Lake, MN 55372-9228
Phone (952) 999-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Domier Chiropractic, PLLC Chiropractor CurrentSince May 10, 2023 Accepting new patients
Pathways Chiropractic Health Center of Prior Lake, PA Chiropractor CurrentSince Jun 14, 2016 Accepting new patients

Locations

16180 Hastings Ave SE
Ste 202
Prior Lake, MN 55372
Phone (952) 991-1353

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1609112622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19057 OAK GROVE AVE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723483",
            "telephone_number": "612-207-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE STE 202",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729228",
            "telephone_number": "952-999-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMIER",
        "first_name": "BRITTANY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.