Active NPI
Dominic Ilardi, PT, DPT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1154912574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4184
- Practice address
- 2725 S 144TH St Ste 212
Omaha, NE 68144-5253 - Phone
- (402) 609-3000
- Fax
- (402) 609-3808
- NPI assigned
- Jan 28, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 018186 | OH | |
| Physical Therapist | 225100000X | 4184 | NE | Primary |
Addresses
Primary practice location
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Mailing address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 609-3000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4184 | NE | MD | Mental Health Counselor |
| 018186 | OH | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1154912574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 S 144TH ST STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445253",
"telephone_number": "402-609-3000",
"fax_number": "402-609-3808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 S 144TH ST STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445253",
"telephone_number": "402-609-3000",
"fax_number": "402-609-3808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILARDI",
"first_name": "DOMINIC",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-28",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "OH",
"license": "018186",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "4184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.