Johanna Kanerva Domer, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

U6945 Issued in TX

Practice address

6621 Fannin St
Houston, TX 77030-2358

Phone

(832) 824-1000

NPI assigned

Mar 7, 2012

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Female

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

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jdomer465460@prddirect.texaschildrens.org

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1093089187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 E CACTUS RD",
            "address_2": "SUITE 940",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544163",
            "telephone_number": "480-443-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302358",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4848 E Cactus Rd",
            "address_2": "Suite 940",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852544163",
            "country_code": "US",
            "telephone_number": "480-443-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMER",
        "first_name": "JOHANNA",
        "middle_name": "KANERVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "29475",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U6945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vickie Domaschk, M.A.
• Ann Madeline Domask, M.D.
• Sarah Dombalis
• Michael T Dome, PA-C
• Marite Domenech-Newhoues, RD, LD
• Karen S. Domin, BCBA 1-21-49866
• Dominique Domingo
• Nicole Domingo
• Raymond Padolina Domingo, M.D.
• Kylan Domingue

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.