Domingo Gonzales Javier, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

10588 Issued in WV

Practice address

1701 Jefferson St
Bluefield, WV 24701-1701

Phone

(304) 325-5755

Fax

(304) 323-1639

NPI assigned

Sep 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Domingo G Javier MD Inc

  • General Practice Physician
  • Bluefield, WV
  • NPI 1588755813
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699872135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 JEFFERSON ST",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247011701",
            "telephone_number": "304-325-5755",
            "fax_number": "304-323-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 JEFFERSON ST",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247011701",
            "telephone_number": "304-325-5755",
            "fax_number": "304-323-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER",
        "first_name": "DOMINGO",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "10588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "1022384",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "851945",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC ANTHEM",
            "identifier": "062480",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "103541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA MED ASSIS",
            "identifier": "7350431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA FUNDS",
            "identifier": "0472131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "V000267",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0127512000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4454937",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Medical Bluefield LLC
• Island Medical Bluefield LLC
• Eddie Jackson
• Jain and Olmsted Partnership
• Teresa E. Jarrell, M.A.
• Shavese Keitary Jenkins
• Emmanuel Jennings
• Noah Jennings
• Melissa Jessee
• Jessica Cole Professional Counseling, LLC

• General Practice Physician in Bluefield, WV
• Providers in Bluefield, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.