Individual provider Active NPI

Joseph David Dominici IV, CRNA

  • Certified Registered Nurse Anesthetist
  • Augusta, GA
National Provider Identifier
1639282353
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-CRNA134362 Issued in GA
Practice address
1 Freedom Way # 222
Augusta, GA 30904-6258
Phone
(706) 733-0188
NPI assigned
Aug 16, 2006
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN-CRNA134362 GA Primary

Addresses

Primary practice location

1 Freedom Way # 222
Augusta, GA 30904-6258

Mailing address

4711 Durham Rd
Grovetown, GA 30813-5229
Phone (706) 210-1642

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-CRNA134362GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Physician Services LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1639282353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 DURHAM RD",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135229",
            "telephone_number": "706-210-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY # 222",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICI",
        "first_name": "JOSEPH",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "APRN-CRNA134362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.