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DOMINIQUE MERLE MACK
NPI 1003603689
Physician Assistant in Omaha, NE

Active since April 24, 2025
1813 N 73RD ST, OMAHA, NE 68114(402) 991-5070 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dominique Merle Mack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIQUE MERLE MACK (NPI 1003603689) is an individual physician assistant in Omaha, Nebraska, licensed in Nebraska (H14171394) and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1003603689
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDOMINIQUE MERLE MACK
Location Address1813 N 73RD STOmaha, NE 68114-1905
Mailing Address1813 N 73rd StOmaha, NE 68114-1905
Phone(402) 991-5070
Sole ProprietorNo
Enumeration DateApril 24, 2025
NPPES CertifiedApril 24, 2025
✔ NPI 1003603689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NE · H14171394
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1813 N 73RD ST, Omaha, NE 68114
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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILFRIED WANGO
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
MARTAVIUS C PENNINGTON
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
LINDA JACKSON
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
CODY KOGER
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
ABDULKADIR OMAR
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
ATSOU YAO OBYMPE
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
ABDULLAHI BURALE
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583
KOFFI SAMUEL ATILA
Student in an Organized Health Care Education/Training Program
1813 N 73RD ST
OMAHA, NE 68114
Douglas County (402) 557-8583

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Mack's NPI number?

The NPI number for Dominique Mack is 1003603689. It was assigned to this individual provider in the NPPES registry on April 24, 2025.

Where is Dominique Mack located?

Dominique Mack practices at 1813 N 73rd St, Omaha, NE 68114. The listed phone number is (402) 991-5070.

What is Dominique Mack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Dominique Mack was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.