C M DOMINGUE (NPI# 1073571824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073571824 |
| Entity Type | Individual |
| Full Name | C M DOMINGUE |
| Credential | M.D. |
| Practice Address |
706 Ross St Oak Grove LA 71263-9798 |
| Practice Telephone | 3184283237 |
| Practice Fax Number | 3184287896 |
| Mailing Telephone | 3184283237 |
| Mailing Fax Number | 3184286180 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2008-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 021327 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1494208 | 05 |
| Street Address |
706 ROSS ST |
| City | OAK GROVE |
| State | LA |
| Zip Code | 71263-9798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306843826 | West Carroll Health Systems LLC | General Acute Care Hospital | 706 Ross St, Oak Grove, LA 71263-9798 | 2005-06-30 |
| 1407256761 | Lana Herring Crymes | Physician Assistant | 706 Ross St, Oak Grove, LA 71263-9798 | 2014-08-23 |
| 1467898650 | West Carroll Health Systems | Pharmacy | 706 Ross St, Oak Grove, LA 71263-9798 | 2013-05-15 |
| 1356629513 | Sireesha Palkamsetti | Pediatrics | 706 Ross St, Oak Grove, LA 71263-9798 | 2011-07-21 |
| 1790073898 | Tony Ray Ogden | Nurse Practitioner | 706 Ross St, Oak Grove, LA 71263-9798 | 2011-07-11 |
| 1801054283 | West Carroll Home Care | Nursing Care | 706 Ross St, Oak Grove, LA 71263-9798 | 2008-06-02 |
| 1538327432 | West Carroll Home Care | Nursing Care | 706 Ross St, Oak Grove, LA 71263-9798 | 2008-05-28 |
| 1821256728 | West Carroll Home Care | Nursing Care | 706 Ross St, Oak Grove, LA 71263-9798 | 2008-05-28 |
| 1710154232 | West Carroll Health Systems LLC | Psychiatric Unit | 706 Ross St, Oak Grove, LA 71263-9798 | 2008-05-14 |
| 1316125511 | West Carroll Home Care LLC | Nursing Care | 706 Ross St, Oak Grove, LA 71263-9798 | 2008-02-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942850284 | Melba West | Technician | Melba West, 9192 Hwy 585, Oak Grove, LA 71263 | 2019-09-18 |
| 1972975225 | Healing Life Health Center LLC | Community/Behavioral Health | 602 South Constitution Avenue, Oak Grove, LA 71263 | 2015-10-27 |
| 1306193701 | Jeremy David Rawls | Chiropractor | 212 N Front St, Oak Grove, LA 71263 | 2012-08-06 |
| 1538358569 | West Carroll Arc | Day Training, Developmentally Disabled Services | 611 West Jefferson, Oak Grove, LA 71263 | 2007-10-16 |
| 1477750842 | West Carroll Arc | Day Training, Developmentally Disabled Services | 611 West Jefferson St, Oak Grove, LA 71263 | 2007-06-29 |
| 1346463767 | Carroll Nursing Home | Durable Medical Equipment & Medical Supplies | 307 N Castleman Street, Oak Grove, LA 71263 | 2007-04-11 |
| 1376670059 | Karla Welch Robertson | Dentist | 414 Ross St., Oak Grove, LA 71263 | 2007-02-28 |
| 1669529111 | Northstar,tlc Inc. | Durable Medical Equipment & Medical Supplies | 212 E. Jefferson, Oakgrove, LA 71263 | 2007-01-05 |
| 1265500490 | Mark Anthony Portacci | Family Medicine | 706 Ross Street, Oak Grove, LA 71263 | 2006-12-04 |
| 1740268739 | Carroll Nursing Home | Nursing Facility/Intermediate Care Facility | 307 N. Castleman St, Oak Grove, LA 71263 | 2006-01-09 |
| Find all providers in zip 71263 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265500490 | Mark Anthony Portacci | Family Medicine | 706 Ross Street, Oak Grove, LA 71263 | 2006-12-04 |
| 1558467076 | Steve T Gialde | Family Medicine | 302 Se Salem St, Oak Grove, MO 64075-9299 | 2006-09-15 |
| 1871956011 | Adam Joseph Legg | Family Medicine | 302 Se Salem St, Oak Grove, MO 64075-9299 | 2016-04-04 |
| 1811293582 | Carondelet Physician Services Inc | Family Medicine | 1900 S Broadway, Oak Grove, MO 64075-9020 | 2011-01-28 |
| 1164651543 | Maggie Marie Ngar | Family Medicine | 302 Se Salem St, Oak Grove, MO 64075-9299 | 2009-07-07 |
| 1841259264 | Noli Guinigundo | Family Medicine | 706 Ross St, Oak Grove, LA 71263-9798 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568060135 | Audubon Family Medicine LLC | Family Medicine | 2301 Moss St, Lafayette, LA 70501-2125 | 2020-10-15 |
| 1588270581 | Wk Palmetto Family Practice | Family Medicine | 4200 Palmetto Rd, Benton, LA 71006-9420 | 2020-09-16 |
| 1255941498 | Concierge Medical Services | Family Medicine | 4108 Vendome Pl, New Orleans, LA 70125-2739 | 2020-08-03 |
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1760005136 | Partners In Primary Care La PC | Family Medicine | 2900 E Texas St Ste 100, Bossier City, LA 71111-3275 | 2020-05-20 |
| 1871116244 | Partners In Primary Care La PC | Family Medicine | 537 Bertrand Dr Ste F0a, Lafayette, LA 70506-5556 | 2020-05-20 |
| 1578185781 | Prestige Medical Staffing and Marketing | Family Medicine | 4108 Vendome Place, New Orleans, LA 70125 | 2020-05-11 |
| 1487275939 | La Health Solutions-laplace LLC | Family Medicine | 1524 W Airline Hwy, La Place, LA 70068-3725 | 2020-05-06 |
| 1316575434 | Southern Healthcare of Louisiana | Family Medicine | 1340 Gause Blvd W, Slidell, LA 70460 | 2020-04-01 |
| 1780219907 | Shirley Ann Burns | Family Medicine | 1201 South St, Vinton, LA 70668-4509 | 2020-03-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.