Jessica Marie Domire, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NUR-APRN-LIC-146098 Issued in MT

Practice address

140 S Central Ave
Malta, MT 59538

Phone

(406) 654-1953

NPI assigned

Jan 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

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.

• Culbertson Froid Bainville Health Care Corporation

  • Critical Access Hospital
  • Culbertson, MT
  • NPI 1598874232

  Multi-Specialty

  Medicare reassignment NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1790293116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581",
            "city": "MALTA",
            "state": "MT",
            "postal_code": "595380581",
            "telephone_number": "406-301-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S CENTRAL AVE",
            "city": "MALTA",
            "state": "MT",
            "postal_code": "59538",
            "telephone_number": "406-654-1953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Malta",
            "state": "MT",
            "postal_code": "59538",
            "country_code": "US",
            "telephone_number": "406-654-1953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMIRE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-146098",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "NUR-APRN-LIC-146098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sterling James Beck, FNP
• Jesse Brockie, FNP-C
• Care Planning Institute, Inc
• Country Home
• Megan Davis, LCPC
• Fallon Handley, LCPC
• Hi-Line Retirement Center
• Jess NP Family Healthcare
• Kara Meghan Knodel, FNP-C
• Malta Family Health Clinic, PC

• Nurse Practitioner in Malta, MT
• Providers in Malta, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.