Emily J Domaille, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3070-19 Issued in WI

Practice address

1125 N 13TH St
Sheboygan, WI 53081-3281

Phone

(920) 803-1617

Fax

(920) 803-1622

NPI assigned

Apr 10, 2023

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)

Not 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 and National Provider Directory roles.

• Progressive Beginnings, LLC

  • Rehabilitation Clinic/Center
  • Sheboygan, WI
  • NPI 1598886152
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1558056010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813281",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813281",
            "telephone_number": "920-803-1617",
            "fax_number": "920-803-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAILLE",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3070-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Alan Dirker, D.C.
• Shelly Amanda Dobson, BCBA
• Erin Doherty
• Mariah R Dole
• Jamie S Dolfin, P.T.
• Kelly Donnelly Mueller, D.O.
• Katharine A Donohue, FNP-C
• Douglas R. Martin DDS SC
• Rebecca Ann Dourn, COTA
• Madison Dowidat

• Physical Therapy Assistant in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.