NPIMap

Individual provider Active NPI

Dominique Farmer

  • Behavior Technician
  • Bridgeport, CT
National Provider Identifier
1740993138
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
215 Alfred St Apt 511
Bridgeport, CT 06605-2982
Phone
(860) 680-3146
NPI assigned
Dec 30, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

215 Alfred St Apt 511
Bridgeport, CT 06605-2982

Mailing address

215 Alfred St Apt 511
Bridgeport, CT 06605-2982
Phone (860) 680-3146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dominique.farmer@waldenu.edu Other

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1740993138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 ALFRED ST APT 511",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052982",
            "telephone_number": "860-680-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 ALFRED ST APT 511",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052982",
            "telephone_number": "860-680-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-30",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dominique.farmer@waldenu.edu",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "no",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "no",
            "address_1": "215 Alfred St Apt 511",
            "city": "Bridgeport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "066052982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.