Individual provider Active NPI

Renee L Dominy, P.T., D.P.T.

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1093822504
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2455 Issued in NE
Practice address
770 N Cotner Blvd Ste 125
Lincoln, NE 68505-2377
Phone
(402) 464-6141
Fax
(402) 464-6142
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2455 NE Primary

Addresses

Primary practice location

770 N Cotner Blvd Ste 125
Lincoln, NE 68505-2377

Mailing address

770 N Cotner Blvd Ste 125
Lincoln, NE 68505-2377
Phone (402) 464-6141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110628000037 NE Practitioner - Physical Therapist in Private Practice 5193903938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Physical Therapy LLCGroup PAC ID 7416108766, 5 clinicians

Practice addresses (Care Compare)

4220 Pioneer Woods Dr
Lincoln, NE 68506-7564
Phone (402) 483-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2455NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Physical Therapy LLC Physical Therapist CurrentSince Oct 5, 2015 Accepting new patients

Locations

4220 Pioneer Woods Dr
Lincoln, NE 68506
Phone (402) 483-0006

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1093822504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 N COTNER BLVD STE 125",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052377",
            "telephone_number": "402-464-6141",
            "fax_number": "402-464-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 N COTNER BLVD STE 125",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052377",
            "telephone_number": "402-464-6141",
            "fax_number": "402-464-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINY",
        "first_name": "RENEE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.