Katherine Mary Domenici, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3625 Issued in NH

Practice address

134 Hall St Unit 1
Concord, NH 03301-3470

Phone

(603) 224-4540

Fax

(603) 228-7384

NPI assigned

Jul 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Pediatric Physical Therapy IncGroup PAC ID 8224376835, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Pediatric Physical Therapy, Inc

  • Physical Therapist
  • Concord, NH
  • NPI 1558539395
  Care Compare group NPD

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1053609552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 RUNNELLS RD",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033033908",
            "telephone_number": "603-209-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HALL ST UNIT 1",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013470",
            "telephone_number": "603-224-4540",
            "fax_number": "603-228-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENICI",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053609551",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Paul Doherty, MS CCC SLP
• Jane Mary Doherty, NP
• Jennifer E Doherty, APRN
• Michael Joseph Doiron, RPH, MBA
• Madeline Dolins
• Lynne Domingue
• Scott Cameron Doner, D.D.S.
• Bradley Stephen Donesky
• Cheryl A Donlon, M.ED., LCMHC
• David Alan Donnelly, M.D.

• Physical Therapist in Concord, NH
• Providers in Concord, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.