Domonique McCall

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

000000000 Issued in LA

Practice address

2252 Snowbird Dr
Harvey, LA 70058-5433

Phone

(504) 258-5695

NPI assigned

Sep 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1972154904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2252 SNOWBIRD DR",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700585433",
            "telephone_number": "504-258-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2252 SNOWBIRD DR",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700585433",
            "telephone_number": "504-258-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "DOMONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "000000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rjdtransportation@yahoo.com",
            "affiliation": "N",
            "address_1": "2252 Snowbird Dr",
            "city": "Harvey",
            "state": "LA",
            "country_code": "US",
            "postal_code": "700585433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Harvey, LA
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• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.