Domergue D Willingham, LMT, MMT, C.M.A.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0019015125 Issued in VA

Practice address

4300 Portsmouth Blvd Ste 262
Chesapeake, VA 23321-2138

Phone

(757) 270-6469

NPI assigned

Jul 11, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Medical Assistant

State licenses

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1992542427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 SUNKIST RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213122",
            "telephone_number": "757-270-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PORTSMOUTH BLVD STE 262",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233212138",
            "telephone_number": "757-270-6469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4004 Sunkist Rd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233213122",
            "country_code": "US",
            "telephone_number": "757-270-6469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "DOMERGUE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LMT, MMT, C.M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019015125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Elizabeth Williams
• Sheriyse Williams, PHD
• Stanisha Natrice Williams, PMHNP-BC, AGPCNP-C
• Tatiana L. Williams, MA
• Veronica Williams, FNP
• J. Dewey Willis III, D.D.S
• Renae Willis, LCSW
• Markita Willit
• Haley Ann Willms
• Stacey Marie Willoughby

• Massage Therapist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Massage Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.