Individual provider Active NPI

Emily Chastain Domingue

  • Audiologist-Hearing Aid Fitter
  • Spanish Fort, AL
National Provider Identifier
1790262996
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
1206A Issued in AL
Practice address
8230 Spanish Fort Blvd
Suite C
Spanish Fort, AL 36527
Phone
(251) 525-0734
NPI assigned
Jul 20, 2018
Last updated
May 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1206A AL
Audiologist-Hearing Aid Fitter 237600000X 1206A AL Primary

Addresses

Primary practice location

8230 Spanish Fort Blvd
Suite C
Spanish Fort, AL 36527

Mailing address

8230 Spanish Fort Blvd
Suite C
Spanish Fort, AL 36527
Phone (512) 250-7343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603000239 AL Practitioner - Qualified Audiologist 6406189786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nautilus Hearing Audiologist CurrentSince May 1, 2020 Accepting new patients

Locations

8230 Spanish Fort Blvd
#C
Spanish Fort, AL 36527
Phone (251) 350-7343

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1790262996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 SPANISH FORT BLVD",
            "address_2": "SUITE C",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "36527",
            "telephone_number": "512-250-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 SPANISH FORT BLVD",
            "address_2": "SUITE C",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "36527",
            "telephone_number": "251-525-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUE",
        "first_name": "EMILY",
        "middle_name": "CHASTAIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "1206A",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AL",
            "license": "1206A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fort, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.