Mirnouve Domond, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

84233 Issued in GA

Practice address

2545 Lawrenceville Hwy Ste 200
Decatur, GA 30033-3240

Phone

(770) 934-7876

Fax

(770) 491-8434

NPI assigned

Apr 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DABBDD

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Lawrenceville Family Practice

  • Health Maintenance Organization
  • Lawrenceville, GA
  • NPI 1831378249
  Medicare reassignment NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Inspira Health Network

  • General Acute Care Hospital
  • Vineland, NJ
  • NPI 1508270299
  NPD (past)
• Inspira Health Network

  • Obstetrics & Gynecology Physician
  • Vineland, NJ
  • NPI 1639557804
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1609296052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 LAWRENCEVILLE HWY STE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333240",
            "telephone_number": "770-934-7876",
            "fax_number": "770-491-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 LAWRENCEVILLE HWY STE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333240",
            "telephone_number": "770-934-7876",
            "fax_number": "770-491-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMOND",
        "first_name": "MIRNOUVE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "84233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisha Dodson, BS
• Emmett John Doerr Jr., MD
• Dogwood Healing Arts
• Tara Doleman, PHARM. D.
• Heather C. Domingue, PHD
• Donald C Siegel MD PC
• Donald C, Siegel, M.D., F.a.C.S.
• Candace Donaldson-Scott
• Justin Donaldson, PH.D.
• Patricia Colquhoun Donaldson I, RN

• Internal Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.