Mara J Dominguez, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024172699 Issued in VA

Practice address

2740 Bensley Commons Blvd
North Chesterfield, VA 23237-1723

Phone

(804) 780-0840

NPI assigned

Jun 26, 2015

Last updated

Jun 2, 2016By the provider in NPPES

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 VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Fredericksburg Area Health and Support Services

  dba Mosaic Care Center

  • Family Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1104170398
  Medicare reassignment NPD
• Vernon J Harris East End Community Health Center

  dba Capital Area Health Network

  • Federally Qualified Health Center (FQHC)
  • Richmond, VA
  • NPI 1295707966
  Medicare reassignment NPD
• Vernon J Harris East End Community Health Center

  dba Capital Area Health Network - Henderson Health Services

  • Federally Qualified Health Center (FQHC)
  • Richmond, VA
  • NPI 1366920530
  NPD
• Vernon J Harris East End Community Health Center

  dba Capital Area Health Network - Vernon J. Harris Medical Center

  • Federally Qualified Health Center (FQHC)
  • Richmond, VA
  • NPI 1972636330
  NPD
• Vernon J Harris East End Community Health Center

  dba Capital Area Health Network - Bermuda Medical Center

  • Federally Qualified Health Center (FQHC)
  • North Chesterfield, VA
  • NPI 1710225818
  NPD (past)

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1700268745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 BENSLEY COMMONS BLVD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232371723",
            "telephone_number": "804-780-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 BENSLEY COMMONS BLVD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232371723",
            "telephone_number": "804-780-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARA",
        "middle_name": "J",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024172699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khristina Dockery, RN
• Katherine Doctor, ATC
• Brittney Elizabeth Dodt, NP
• Doing Our P.a.R.T. LLC
• Sean Dolan, DPT
• Tim D Dominick, PA-C
• Dominion Behavioral Healthcare of Chesterfield
• Jeffrey Donahue, MD
• Rae-Anne Dougan
• Jasmine E Douglas

• Nurse Practitioner in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.