NPIMap

Individual provider Active NPI

Rachel I Sigel Domenico, FNP-BC

  • Family Nurse Practitioner
  • Inwood, WV
National Provider Identifier
1740269208
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
41872 Issued in WV
Practice address
5047 Gerrardstown Rd Ste 2a
Inwood, WV 25428-3951
Phone
(304) 229-2273
NPI assigned
Jan 12, 2006
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024164223 VA
Family Nurse Practitioner 363LF0000X 41872 WV Primary

Addresses

Primary practice location

5047 Gerrardstown Rd Ste 2a
Inwood, WV 25428-3951

Mailing address

2500 Foundation Way
Martinsburg, WV 25401-9000
Phone (304) 264-9202

Other identifiers 1

IdentifierTypeStateIssuer
3810019769MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000874 WV Practitioner - Nurse Practitioner 7719002906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Memorial HospitalGroup PAC ID 0446151989, 33 clinicians

Practice addresses (Care Compare)

300 S Preston St
Ranson, WV 25438-1631
Phone (304) 728-1669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024164223VAMDFamily Nurse Practitioner
41872WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Memorial Hospital CurrentSince Jun 30, 2022 Accepting new patients
Jefferson Memorial Hospital CurrentSince Jun 30, 2022 Accepting new patients
Jefferson Memorial Hospital Current Accepting new patients
University Healthcare Physicians Inc Past Accepting new patients
University Healthcare Physicians, Inc. Family Past Accepting new patients
University Healthcare Physicians, Inc. PastSince Nov 6, 2022 Accepting new patients
Jefferson Memorial Hospital Past Accepting new patients

Locations

300 S Preston St
Ranson, WV 25438
Phone (304) 728-1600

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1740269208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FOUNDATION WAY",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019000",
            "telephone_number": "304-264-9202",
            "fax_number": "304-264-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 GERRARDSTOWN RD STE 2A",
            "city": "INWOOD",
            "state": "WV",
            "postal_code": "254283951",
            "telephone_number": "304-229-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGEL DOMENICO",
        "first_name": "RACHEL",
        "middle_name": "I",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164223",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "41872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019769",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inwood, WV

Sources for this page

Verify at the official NPI Registry.