Deanna Domnisch

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38897 Issued in FL

Practice address

2307 S Dale Mabry Hwy Ste F
Tampa, FL 33629-6322

Phone

(813) 374-9508

NPI assigned

Nov 4, 2013

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Deanna Favero Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Potentia Therapeutics, LLCGroup PAC ID 6103181888, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Potentia Therapeutics, LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1063910982
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1396174017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 S HIMES AVE APT 801",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112622",
            "telephone_number": "716-696-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 S DALE MABRY HWY STE F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296322",
            "telephone_number": "813-374-9508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Lenfant Plz SW Ste 602",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200242124",
            "country_code": "US",
            "telephone_number": "202-863-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMNISCH",
        "first_name": "DEANNA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208347",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871510",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "FAVERO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Brandon Dominguez, MD
• Roberto V Dominguez, M.D.
• Maria Dominick, RPH
• Cleone Dominique
• Michael Eugene Domis, DPM
• Donna Malin Donaghy, BA
• Amy Katherine Donahey, APRN
• Donald F Temple MD PA
• Susan Lea Donald, NS CCC SLP
• Taylor Donald, MD

• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.