Individual provider Active NPI

Brittany M Dominguez

  • Registered Nurse
  • Ebensburg, PA
National Provider Identifier
1629765003
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN764878 Issued in PA
Practice address
429 Manor Dr
Ebensburg, PA 15931-4917
Phone
(814) 472-6060
NPI assigned
Apr 18, 2023
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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 RN764878 PA Primary

Addresses

Primary practice location

429 Manor Dr
Ebensburg, PA 15931-4917

Mailing address

246 Pennway Dr
Nanty Glo, PA 15943-3411
Phone (814) 505-6320

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

State licenses

LicenseStateTypeSpecialty
RN764878PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1629765003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 PENNWAY DR",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159433411",
            "telephone_number": "814-505-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 MANOR DR",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314917",
            "telephone_number": "814-472-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "BRITTANY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN764878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.