Nathan Andrew Domino, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-30034 Issued in AZ

Practice address

2940 E Banner Gateway Dr Ste 200-250
Gilbert, AZ 85234-2168

Phone

(602) 648-5444

Fax

(602) 772-3801

NPI assigned

May 13, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1700232220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DR STE 200-250",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342168",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINO",
        "first_name": "NATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2022-05-10",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30034",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "072900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Powell Dolan, MD, MPH
• Ray Dolberry, BOCPO
• Jennifer Dominguez
• Rebecca Conrad Dominguez, MD
• Omar L Dominique, M.D.
• Maliyah Donaldson, RBT
• Gordon Trent Doneskey, M.D.
• Lauren Mae Donnelly
• Erin Dooley, MSN, APRN, PMHNP-BC
• Annabelle Doran

• Physical Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physical Therapist in Arizona

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