Douglass T. Domoto, M.D., J.D., P.C.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

R6C21 Issued in MO

Legal business name

DOUGLASS T. DOMOTO, M.D., J.D., P.C.

Practice address

2606 Clark Ave
Ave
Saint Louis, MO 63103-2502

Phone

(314) 535-3720

Fax

(314) 535-7391

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Douglass Takashi Domoto, M.D., J.D.

Title

President

Phone

(314) 535-3720

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rashid Ahmed Dalal, MD

  • Nephrology Physician
  • Fairview Heights, IL
  • NPI 1265434815
  NPD (past)

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1124337373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 CLARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032502",
            "telephone_number": "314-535-3720",
            "fax_number": "314-535-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 CLARK AVE",
            "address_2": "AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032502",
            "telephone_number": "314-535-3720",
            "fax_number": "314-535-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLASS T. DOMOTO, M.D., J.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "DOMOTO",
        "authorized_official_first_name": "DOUGLASS",
        "authorized_official_middle_name": "TAKASHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-535-3720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., J.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "R6C21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyler Michael Douglas, DO
• Mary Ellen Douglas, BSW
• Teconda Lashelle Douglas, ANP-BC
• Trelford Owen Matthew Douglas, MD
• Zachary Hill Douglas, MD
• Elizabeth Jones Douglass, MSW,MAED,LCSW
• Jhony Y Doumit, MD
• Douthit Home Care Services, LLC
• Traci R Doutre, NBC-HWC
• Dove Cares CDS, LLC

• Nephrology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nephrology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.