Maryann Theresa Dominguez, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305004526 Issued in VA

Practice address

2820 Waterford Lake Dr Ste 103
Midlothian, VA 23112-3994

Phone

(804) 249-8277

Fax

(804) 249-9690

NPI assigned

Jul 15, 2005

Sex

Female

Sole proprietor

No

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)

Enrolled

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 and National Provider Directory roles.

• Virginia Center for Spine & Sports Therapy LLC

  • Physical Therapy Clinic/Center
  • Midlothian, VA
  • NPI 1598861395

  Physical Therapist

  NPD Authorized official

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1437158102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LADY MARIAN LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131178",
            "telephone_number": "804-677-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 WATERFORD LAKE DR STE 103",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123994",
            "telephone_number": "804-249-8277",
            "fax_number": "804-249-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARYANN",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa N Dobransky, MD
• Tanner Jackson Dobrucky, DC
• Susanna Mulas Dodd, RPH
• Margaret A Dolan, M.D.
• Martin Henninger Dominguez, DPT
• Caroline Anne Dominick
• Dominion Behavioral Healthcare
• Dominion Foot and Ankle Center,LTD.
• Dominion Healthcare Resources, Inc.
• Mary Nell Donahue

• Physical Therapist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.