Kathleen Kang Domm, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30181 Issued in SC

Practice address

2051 Charlie Hall Blvd
Charleston, SC 29414-5834

Phone

(843) 573-2535

Fax

(843) 573-2534

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Kathleen Kang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kathleen.domm.1@15910.direct.athenahealth.com

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1679614762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-573-2535",
            "fax_number": "843-573-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-573-2535",
            "fax_number": "843-573-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMM",
        "first_name": "KATHLEEN",
        "middle_name": "KANG",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A86527",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "30181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KANG",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew David Dominguez, MD
• Taryn Michelle Dominguez, LISW-CP
• Alexandra Nicole Dominianni, MD
• Anthony Michael Dominick, D.O.
• Dominique Bultsma MD PC
• Danielle Donadio, MGC
• Colleen Donahue, M.D.
• Megan Donaldson, DO
• Paul Edmund Donatelli, M.D.
• Annemarie Sipkes Donato, APRN

• Pediatrics Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.