Tara Renee Dominguez, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1105159 Issued in KS

Practice address

10400 W 103Rd St Ste 22
Overland Park, KS 66214-2664

Phone

(913) 322-4000

NPI assigned

Aug 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Core Strategies

  • Physical Therapy Clinic/Center
  • Overland Park, KS
  • NPI 1841674033
  NPD (past)
• Elite Sports Medicine & Physical Therapy LC

  • Physical Therapy Clinic/Center
  • Leawood, KS
  • NPI 1174699045

  Physical Therapist

  NPD (past)
• Modern Physical Therapy PC

  • Physical Therapist
  • Kansas City, MO
  • NPI 1831136662
  NPD (past)

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1346497534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 W 103RD ST",
            "address_2": "STE 22",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662142664",
            "telephone_number": "913-322-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 W 103RD ST STE 22",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662142664",
            "telephone_number": "913-322-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13157 State Line Rd",
            "address_2": "Suite201",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641451650",
            "country_code": "US",
            "telephone_number": "816-941-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "TARA",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KS",
            "license": "1105159",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008024821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darius Kevon Dodson
• Aaron Michael Dold, PHARMD
• John Andrew Dolenz, D.D.S.
• Katie Jill Dollar, PHARMD
• Xavier Domenech
• Leslie Suzanne Domsch, APRN
• Donald B. Wilcoxon D.D.S, M.S., PA
• Bayli Nikole Donaldson, PA-C
• Cheryl Petty Donaldson, LCMFT
• Michelle Renee Donaldson, RPH

• Orthopedic Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Orthopedic Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.