EDGAR ANTONIO DOMENECH
NPI 1770191629
Student in an Organized Health Care Education/Training Program in Fayetteville, NC
About Edgar Antonio Domenech NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDGAR ANTONIO DOMENECH (NPI 1770191629) is an individual student in an organized health care education/training program in Fayetteville, North Carolina and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Ponce.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Edgar Antonio Domenech is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAYETTEVILLE, NC 28304
FAYETTEVILE, NC 28304
FAYETTEVILLE, NC 28304
FAYETTEVILLE, NC 28304
FAYETTEVILLE, NC 28304
FAYETTEVILLE, NC 28304
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 Edgar Domenech's NPI number?
The NPI number for Edgar Domenech is 1770191629. It was assigned to this individual provider in the NPPES registry on July 16, 2020.
Where is Edgar Domenech located?
Edgar Domenech practices at 1638 Owen Drive, Fayetteville, NC 28304. The listed phone number is (910) 615-4000.
What is Edgar Domenech's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Edgar Domenech enrolled in Medicare?
Yes. Edgar Domenech is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Edgar Domenech was last updated on April 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Edgar Antonio Domenech · NPI 1770191629
Student in an Organized Health Care Education/Training Program provider in Fayetteville, North Carolina. Individual provider, active in the CMS NPPES registry since July 16, 2020.
## Identity
- **NPI:** 1770191629 (Entity type: Individual)
- **Enumerated:** July 16, 2020
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1638 OWEN DRIVE, Fayetteville, NC 28304
- **Phone:** (910) 615-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 8, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1770191629) · Data from the CMS NPPES public registry.