Dominique Bowman Anderson, DNP, FNP, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Baton Rouge, LA
NPI 1992289045 · NPPES record last updated Jun 1, 2021
Key facts
- NPI
- 1992289045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- AP10001 (LA)
- Practice address
- 3401 North Blvd Ste 100
Baton Rouge, LA 70806-3743 - Phone
- (225) 381-2621
- Fax
- (225) 387-7829
- NPI assigned
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Baton Rouge General Physicians Inc
Baton Rouge Clinic, a Medical Corporation
Practice addresses (Care Compare)
3401 N Blvd
Baton Rouge, LA 70806-3743
Phone (225) 387-7900
7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190103000794 | LA | Practitioner - Nurse Practitioner | 2860737343 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP10001 | LA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Tammany Emergency Physicians Group LLC | Current |
Accepting new patients | |
| St. Helena Parish Hospital | Current |
Accepting new patients | |
| Baton Rouge Clinic, a Medical Corporation | Current |
Accepting new patients | |
| Baton Rouge General Physicians, Inc. | Current |
Accepting new patients | |
| Thibodaux Emergency Physicians Group LLC | Current |
Accepting new patients | |
| Ascension Emergency Physicians LLC | Current |
Accepting new patients | |
| Baton Rouge Clinic, a Medical Corporation | Current |
Accepting new patients | |
| Baton Rouge General Physicians, Inc. | Current |
Accepting new patients | |
| Coolidge Emergency Group LLC | Nurse Practitioner | Current |
Accepting new patients |
| St Helena Parish Hospital | Past |
Accepting new patients | |
| Baton Rouge Recovery Health LLC | Past | Accepting new patients |
Locations
4045 North Blvd
Baton Rouge, LA 70806
Phone (225) 381-2570
3401 North Blvd
Ste 100
Baton Rouge, LA 70806
Phone (225) 381-2621
8595 Picardy Ave
Ste 320
Baton Rouge, LA 70809
Phone (225) 237-1880
933 N Foster Dr
Baton Rouge, LA 70806
Phone (225) 381-2541
8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000
7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790
3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615
3401 North Blvd
Ste 130
Baton Rouge, LA 70806
Phone (225) 381-2789
1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743
1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975
1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191
602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544
Interoperability endpoints
- danderson1050075@direct.casso.us.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | AP10001 | LA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP10001 | LA | Yes |
Addresses
Primary practice location
3401 North Blvd Ste 100
Baton Rouge, LA 70806-3743
Mailing address
7373 Perkins Rd
Baton Rouge, LA 70808-4373
Phone (225) 246-9790
Other practice location 1
19 N 1st St
Greensburg, LA 70441-0059
Phone (225) 222-3681
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2485385 | Medicaid | LA |
Other providers in Baton Rouge, LA
- Carol Anderson
- Chloe Anderson
- Coleta L Anderson
- Darcy Marie Anderson
- Derek James Anderson
- Emily Adele Anderson
- Emily Kristen Anderson
- Gabrielle Anderson
- Halisha Anderson
- Hannah Marie Anderson
All providers in Baton Rouge, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.