Individual provider Active NPI

Samantha Dominguez, APRN, FNP-C

  • Family Nurse Practitioner
  • Hereford, TX
National Provider Identifier
1861248957
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1150890 Issued in TX
Practice address
540 W 15TH St
Hereford, TX 79045-2820
Phone
(806) 364-2141
NPI assigned
Apr 29, 2024
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1150890 TX Primary

Addresses

Primary practice location

540 W 15TH St
Hereford, TX 79045-2820

Mailing address

540 W 15TH St
Hereford, TX 79045-2820

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240809000259 TX Practitioner - Nurse Practitioner 9830636703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

540 W 15TH St
Hereford, TX 79045-2820

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1150890TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaf Smith County Hospital District CurrentSince Jun 21, 2024 Accepting new patients
Deaf Smith County Hospital District CurrentSince Jun 21, 2024 Accepting new patients
Deaf Smith County Hospital District Past Accepting new patients

Locations

504 W 15TH St
Hereford, TX 79045

540 W 15th St
Hereford, TX 79045
Phone (806) 364-2141

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1861248957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W 15TH ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790452820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 15TH ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790452820",
            "telephone_number": "806-364-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "SAMANTHA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1150890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hereford, TX

Sources for this page

Verify at the official NPI Registry.