Individual provider Active NPI

Karen Francisco Domanski, RPT

  • Physical Therapist
  • Fort Pierce, FL
National Provider Identifier
1114102977
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015544 Issued in IL
Practice address
700 S 29TH St
Fort Pierce, FL 34947-3626
Phone
(772) 465-7560
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 070015544 IL Primary

Addresses

Primary practice location

700 S 29TH St
Fort Pierce, FL 34947-3626

Mailing address

1290 SW Briarwood Dr
Port Saint Lucie, FL 34986-2333
Phone (309) 333-5679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070015544ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1114102977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SW BRIARWOOD DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862333",
            "telephone_number": "309-333-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S 29TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473626",
            "telephone_number": "772-465-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANSKI",
        "first_name": "KAREN",
        "middle_name": "FRANCISCO",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.