David J Domenico

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA01238 Issued in RI

Practice address

261 Main St
North Smithfield, RI 02896-7919

Phone

(401) 356-4777

NPI assigned

Mar 28, 2022

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1336899582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 CAPORAL ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MAIN ST",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028967919",
            "telephone_number": "401-356-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENICO",
        "first_name": "DAVID",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "RI",
            "license": "PTA01238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepthi S Cull MD PA (Avant-Garde Medicine)
• Jennifer Desautels
• James Edward Devine III, DMD
• Erik Dingley, O.D
• Janette Dion Roy, LICSW
• Joseph K Domenico, D.P.M.
• Susan M. Donahue, D.C.
• Jodie Lynne Drapeau, RN
• DRS Dubois & Dubois LTD
• Evans Agyemang Duah, PMHNP

• Physical Therapy Assistant in North Smithfield, RI
• Providers in North Smithfield, RI by specialty
• Physical Therapy Assistant in Rhode Island

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