Darrel Dominique, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A7461 Issued in LA

Practice address

16 Heyman LN
Lexington House
Alexandria, LA 71303-3523

Phone

(318) 442-4364

NPI assigned

Dec 22, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lexington House LLC

  • Skilled Nursing Facility
  • Alexandria, LA
  • NPI 1467490912
  NPD (past)

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

{
    "created_epoch": "1356134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356307200000",
    "number": "1003152885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 PARK DR S",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700013328",
            "telephone_number": "504-875-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HEYMAN LN",
            "address_2": "LEXINGTON HOUSE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033523",
            "telephone_number": "318-442-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIQUE",
        "first_name": "DARREL",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-22",
        "last_updated": "2012-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A7461",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2088460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andrew Dodson, MD
• Debbie Jane Doggett, FAMILY NURSE PRACTIT
• Tina Stafford Doggett, NP
• Michael W Dole, MD
• Jessica Dolin
• Lisa Venable Dommert, RPH
• Angelina Donahue
• Shawn Elizabeth Donelon, M.D.
• Laurie A Doolittle, CRNA
• Door of Hope Counseling and Consulting, LLC

• Physical Therapy Assistant in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Physical Therapy Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; 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.