Doma Oh LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

DOMA OH LLC

Practice address

1607 Mount Curve Ave
Minneapolis, MN 55403-1015

Phone

(612) 695-6041

NPI assigned

Jun 12, 2024

Organization subpart

Yes

Parent organization

EVOLVE CARE LLCAs reported in NPPES

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

Authorized official

Name

Blake Elliott

Title

Owner

Phone

(612) 695-6041

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1427890128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 MOUNT CURVE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 MOUNT CURVE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031015",
            "telephone_number": "612-695-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMA OH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVOLVE CARE LLC",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-695-6041"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Becker Dolezal, MA, ATC, CSCS
• Tammy L. Doll, LICSW
• Emma Reese Dolphin
• Devin Dolquist
• Rachel Dols, REGISTERED NURSE
• David Edward Domaas, DDS
• Jill Dombrowski
• Domestic Abuse Project
• Evidio Domingo Musibay, MD
• Kristine Domingo

• Developmental Disabilities Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Developmental Disabilities Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.