Dominecia Jamille Maxwell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1057353 Issued in TX

Practice address

490 US Highway 80 E Ste 200
Sunnyvale, TX 75182-9220

Phone

(972) 329-1996

NPI assigned

Oct 21, 2021

Sex

Female

Sole proprietor

No

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 TX

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total MD Physicians Group, PLLCGroup PAC ID 7012313521, 127 clinicians

Practice addresses (Care Compare)

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.

• Total MD Physicians Group, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1982031852
  Medicare reassignment Care Compare group NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596

  Family Medicine

  Medicare reassignment NPD (past)
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Kaufman, TX
  • NPI 1992151740

  Family Medicine

  NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1811650245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 N. O'CONNOR BLVD",
            "address_2": "SUITE 170",
            "city": "LAS COLINAS",
            "state": "TX",
            "postal_code": "750395752",
            "telephone_number": "469-345-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 US HIGHWAY 80 E STE 200",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751829220",
            "telephone_number": "972-329-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "DOMINECIA",
        "middle_name": "JAMILLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1057353",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1057353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizy Mammoottil
• Abigail Sylvia Martin, PA-C
• Ebony Mason
• Farah Masood, MD
• Jestine Mathew
• Charles W. McDaniel, DO
• James Max McEwan, CRNA
• John Cooper McKee Sr., MD
• Medallion Diagnostics
• Medallion Health Group LLC

• Family Nurse Practitioner in Sunnyvale, TX
• Providers in Sunnyvale, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.
• 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.