Active NPI
Mary Martin Domes, M.S., CCC-SLP
- Speech-Language Pathologist
- Oneida, NY
National Provider Identifier
1821243965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015842-1
- Practice address
- 701 Lenox Ave
Oneida, NY 13421-1500 - Phone
- (315) 363-3397
- NPI assigned
- Nov 17, 2008
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 015842-1 | NY | Primary |
Addresses
Primary practice location
701 Lenox Ave
Oneida, NY 13421-1500
Mailing address
6517 State Route 20
Bouckville, NY 13310-1613
Phone (315) 893-9933
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015842-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226880000000",
"number": "1821243965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6517 STATE ROUTE 20",
"city": "BOUCKVILLE",
"state": "NY",
"postal_code": "133101613",
"telephone_number": "315-893-9933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 LENOX AVE",
"city": "ONEIDA",
"state": "NY",
"postal_code": "134211500",
"telephone_number": "315-363-3397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMES",
"first_name": "MARY",
"middle_name": "MARTIN",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-17",
"last_updated": "2008-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015842-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oneida, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.