Jerren Domino, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1365693 Issued in TX

Practice address

6501 Harris Pkwy
Fort Worth, TX 76132-6102

Phone

(817) 370-9891

Fax

(817) 370-9894

NPI assigned

Aug 25, 2022

Last updated

Aug 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sportherapy LLC

  • Physical Therapy Clinic/Center
  • Fort Worth, TX
  • NPI 1386132132

  Physical Therapist

  NPD
• Sportherapy Southwest, PC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Fort Worth, TX
  • NPI 1801812698

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1225757990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "334-231-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326102",
            "telephone_number": "817-370-9891",
            "fax_number": "817-370-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINO",
        "first_name": "JERREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1365693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estela M Dominguez, AAS
• Sarah Dominguez, LPC
• Michael William Dominisse Jr., PA
• Domino Effects
• Ashley Domino
• Cathryn Donaghey, M.S. SLP CFY
• Sherry Michelle Donahue-Brown
• David J Donahue, MD
• Stephen Manus Donahue, MD
• Samone Donald, LPC

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.