Henry F. Domke, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R6A79 Issued in MO

Practice address

701 W High St
Jefferson City, MO 65101-1525

Phone

(573) 634-5400

Fax

(573) 636-2639

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1811977572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104240",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104240",
            "telephone_number": "573-634-5400",
            "fax_number": "573-636-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W HIGH ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011525",
            "telephone_number": "573-634-5400",
            "fax_number": "573-636-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMKE",
        "first_name": "HENRY",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R6A79",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201319514",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adelia L. Doerhoff, MD
• Alan Roy Doerhoff, M D
• Carl Raymond Doerhoff, M.D.
• Joseph J Doggett, D.O.
• Sarah Ann Domingue
• Shelley Rae Donahue, ECSE, TVI/COMS
• Taylor Donahue
• Stanley K Dorst, MD
• Dora Doss, MS, CCC-SLP
• Sara Doty

• Family Medicine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.