Individual provider Active NPI

Elizabeth Rose Domi, D.C.

  • Chiropractor
  • Escondido, CA
National Provider Identifier
1730216284
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
24630 Issued in CA
Practice address
336 S Broadway
Escondido, CA 92025-4207
Phone
(760) 291-1900
Fax
(760) 737-3101
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 24630 CA Primary

Addresses

Primary practice location

336 S Broadway
Escondido, CA 92025-4207

Mailing address

336 S Broadway
Escondido, CA 92025-4207
Phone (760) 291-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223001106 CA Practitioner - Chiropractic 2961398417 Reassigns benefits to 1 organization
Practice locations: Escondido, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

336 S Broadway
Escondido, CA 92025-4207
Phone (717) 319-7993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24630CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Domi Chiropractic & Wellness Center Chiropractor CurrentSince Jun 14, 2022 Accepting new patients

Locations

336 S Broadway
Escondido, CA 92025
Phone (717) 319-7993

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1730216284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 S BROADWAY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254207",
            "telephone_number": "760-291-1900",
            "fax_number": "760-737-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 S BROADWAY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254207",
            "telephone_number": "760-291-1900",
            "fax_number": "760-737-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMI",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "24630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.