Active NPI
Ross Domke, RPH
- Pharmacist
- Redding, CA
National Provider Identifier
1861195455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36366
- Practice address
- 1811 Trailwood CT
Redding, CA 96003-5352 - Phone
- (530) 356-0229
- NPI assigned
- Mar 23, 2023
- Last updated
- Oct 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36366 | CA | Primary |
Addresses
Primary practice location
1811 Trailwood CT
Redding, CA 96003-5352
Mailing address
1060 E Cypress Ave
Redding, CA 96002-1114
Phone (530) 221-5575
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36366 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1861195455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 E CYPRESS AVE",
"city": "REDDING",
"state": "CA",
"postal_code": "960021114",
"telephone_number": "530-221-5575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 TRAILWOOD CT",
"city": "REDDING",
"state": "CA",
"postal_code": "960035352",
"telephone_number": "530-356-0229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMKE",
"first_name": "ROSS",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-23",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "36366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.