Mark E Domaas LLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

Legal business name

MARK E DOMAAS LLC

Practice address

4450 31St Ave S Ste 102
Fargo, ND 58104-4557

Phone

(763) 218-4771

Fax

(701) 205-4593

NPI assigned

Aug 9, 2019

Last updated

Apr 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Edward Domaas, DPM

Title

President

Phone

(701) 561-3312

Specialties & licenses 1

Addresses

Other names 1

• Advanced Foot & Ankle Other name

Electronic endpoints 1

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1720633373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-561-3312",
            "fax_number": "701-232-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "763-218-4771",
            "fax_number": "701-205-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E DOMAAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "DOMAAS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-561-3312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.fargofootandankle.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "practice information",
            "address_1": "4450 31st Ave S Ste 201",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581044556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Advanced Foot & Ankle",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Advanced Foot & Ankle",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer L Marhula, CDE, LRD
• Antonio Eduardo Marinos, M.D.
• Sarah R Marinov, APRN/CNP
• Abbey Marinucci
• Mariela Rosa Marius
• Mark R Sheils DDS PC
• Mark Rohrer LLC
• Mark Tufte OD PC (Dr. Tufte's Eyes on 45th)
• Clarice Ann Mark, LCSW
• Page Mark

• Primary Podiatric Medicine Podiatrist in Fargo, ND
• Providers in Fargo, ND by specialty
• Primary Podiatric Medicine Podiatrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.