Dominique Pummill, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP03564 Issued in NM

Practice address

601 Martin Luther King Ave NE
Albuquerque, NM 87102-3619

Phone

(505) 288-3173

NPI assigned

Apr 30, 2018

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 NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Exclusive Psychiatric Care LLC 3 clinicians

Otero County Hospital Association 245 clinicians

Thrive Counseling LLC 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dominque.pummill.1@6965.direct.athenahealth.com

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.

• Exclusive Psychiatric Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Cruces, NM
  • NPI 1609267103

  NM, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579

  NM

  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NM

  Medicare reassignment Care Compare group NPD
• Lovelace Health System LLC

  • Clinic/Center
  • Santa Fe, NM
  • NPI 1245798024

  NM

  Medicare reassignment NPD
• Lovelace Health System LLC

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1275711178
  NPD
• Lovelace Health System, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1164137964
  NPD
• Otero County Hospital Association

  • Community/Retail Pharmacy
  • Alamogordo, NM
  • NPI 1235948803
  NPD

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1609364249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 966",
            "city": "FAIRACRES",
            "state": "NM",
            "postal_code": "880330966",
            "telephone_number": "575-805-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MARTIN LUTHER KING AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023619",
            "telephone_number": "505-288-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMMILL",
        "first_name": "DOMINIQUE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP03564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akhil Pulisetty, MD
• Frank Dominic Pullara, M.D.
• Evan Pulliam
• Claire Marie Pultz, PA-C
• Kathryn M Puma, CNP
• Miguel A Pupiales, MD
• Janssen Lao Puracan, MD
• Lee Francis Purcaro, DC
• Carol Purcell, PA-C
• Chelsea Purcell

• All providers in Albuquerque, NM
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.