Dominic Anthony Defrancis, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35-054293 Issued in OH

Practice address

420 Polifka Dr BLDG 1042
Shaw AFB, SC 29152-5100

Phone

(803) 895-6356

NPI assigned

Jul 20, 2006

Last updated

Aug 28, 2024By 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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1285654798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR BLDG 1042",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR BLDG 1042",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Nealy Ave",
            "address_purpose": "LOCATION",
            "city": "Joint Base Langley-Eustis",
            "state": "VA",
            "postal_code": "23665",
            "country_code": "US",
            "telephone_number": "757-225-6611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 Page Rd",
            "address_purpose": "LOCATION",
            "city": "Robins AFB",
            "state": "GA",
            "postal_code": "310981601",
            "country_code": "US",
            "telephone_number": "478-327-1897",
            "fax_number": "478-327-0610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFRANCIS",
        "first_name": "DOMINIC",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-054293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Shaw AFB, SC
• Providers in Shaw AFB, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.