Active NPI
Dominic Irwin, P.T, DPT
- Physical Therapist
- Shelby, OH
National Provider Identifier
1487864955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT.011438
- Practice address
- 20 Morris Rd
Shelby, OH 44875-1152 - Phone
- (419) 342-1724
- Fax
- (419) 342-1797
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT.011438 | OH | Primary |
Addresses
Primary practice location
20 Morris Rd
Shelby, OH 44875-1152
Mailing address
212 Rudy Rd
Mansfield, OH 44903-8036
Phone (419) 342-1724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT.011438 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487864955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 RUDY RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449038036",
"telephone_number": "419-342-1724",
"fax_number": "419-342-1797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MORRIS RD",
"city": "SHELBY",
"state": "OH",
"postal_code": "448751152",
"telephone_number": "419-342-1724",
"fax_number": "419-342-1797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "DOMINIC",
"credential": "P.T, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT.011438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.