Individual provider Active NPI

Baby Lyn Domingo

  • Skilled Nursing Facility
  • Sarasota, FL
National Provider Identifier
1336674928
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PT27123 Issued in FL
Practice address
4498 McIntosh Park Dr Apt 1906
Sarasota, FL 34232-6526
Phone
(727) 366-8957
NPI assigned
Apr 20, 2017
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X PT27123 FL Primary

Addresses

Primary practice location

4498 McIntosh Park Dr Apt 1906
Sarasota, FL 34232-6526

Mailing address

4498 McIntosh Park Dr Apt 1906
Sarasota, FL 34232-6526
Phone (727) 366-8957

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
PT27123FLMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1336674928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4498 MCINTOSH PARK DR APT 1906",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326526",
            "telephone_number": "727-366-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4498 MCINTOSH PARK DR APT 1906",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326526",
            "telephone_number": "727-366-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "BABY LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "PT27123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.