Active NPI
Domcielie Orteza, PT, DPT
- Physical Therapist
- Marion, IL
National Provider Identifier
1730967894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 104 Airway Dr # 1
Marion, IL 62959-5841 - Phone
- (219) 775-2473
- NPI assigned
- Sep 20, 2023
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
104 Airway Dr # 1
Marion, IL 62959-5841
Mailing address
910 Farris St Unit B
Carterville, IL 62918-1110
Other practice location 1
3333 W DeYoung St
Marion, IL 62959-5884
Phone (219) 775-2473
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1730967894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 FARRIS ST UNIT B",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629181110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 AIRWAY DR # 1",
"city": "MARION",
"state": "IL",
"postal_code": "629595841",
"telephone_number": "219-775-2473"
}
],
"practiceLocations": [
{
"address_1": "3333 W DeYoung St",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "IL",
"postal_code": "629595884",
"country_code": "US",
"telephone_number": "219-775-2473",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORTEZA",
"first_name": "DOMCIELIE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.