Theresa M Domagola is a Jacksonville, Florida based nurse practitioner with 22 years of experience in Acute Care. She completed her graduation from University Of Rochester School Of Medicine And Dentistry in 2003. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Theresa M Domagola is 11002747 for Acute Care in Florida. Her current practice location is 15255 Max Leggett Pkwy Ste 3600, Jacksonville. Patients can reach her at 904-427-6895. Theresa M Domagola is ACNP-BC, PMHNP-BC with specialization in Acute Care and her NPI number (Unique professional ID assigned by NPPES) is 1184676322. Theresa M Domagola is a licensed independent practitioner and may autonomously provide care. She provides advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions. This care is continuous and comprehensive and may be provided in any setting where the patient may be found.
Complete Profile:
Theresa M Domagola speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
Name:
Theresa M Domagola
Specialization:
Acute Care Nurse Practitioner (ACNP)
Gender:
Female
Credentials:
ACNP-BC, PMHNP-BC
Experience:
22+ years
Medical School Attended:
University Of Rochester School Of Medicine And Dentistry
Graduation Year:
2003
Accepts Medicare Assignment:
Yes
Practice Address:
15255 Max Leggett Pkwy Ste 3600, Jacksonville, Florida, 32218-7279
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
0840234050
Enrollment ID:
I20191227001192
NPI Number:
1184676322
NPI Enumeration Date:
16 May, 2006
NPI Last Update On:
24 Jun, 2024
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Theresa M Domagola are as mentioned below.
License Number
Specialization
State
Status
11002747
Acute Care
Florida
Primary
430210
Acute Care
New York
Secondary
Hospital Affiliation:
NPs can be affiliated to many hospitals whom they worked with in the past or are presently working with. One NP can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
(100001)
Jacksonville, FL
Acute Care Hospital
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Theresa M Domagola is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
University Of Florida Jacksonville Physicians, Inc. (9133025869)
625
Other Medical Identifiers:
Other legacy medical identifiers associated with Theresa M Domagola such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
70008ARA6884
Other
MCR
02601196
Medicaid
New York
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Theresa M Domagola 15255 Max Leggett Pkwy Ste 3600, Jacksonville, Florida
Zip:
32218-7279
Phone Number:
904-427-6895
Patients can reach Theresa M Domagola at 15255 Max Leggett Pkwy Ste 3600, Jacksonville, Florida or can call to book an appointment on 904-427-6895.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 January, 2025.