Active NPI
Madison Ayers Domico, DPT
- Physical Therapist
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11520
- Practice address
- 225 Baldwin Ave
Charlotte, NC 28204-3109 - Phone
- (704) 376-1605
- NPI assigned
- Aug 23, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P21483 | NC | |
| Physical Therapist | 225100000X | 11520 | SC | Primary |
Addresses
Primary practice location
225 Baldwin Ave
Charlotte, NC 28204-3109
Mailing address
225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, NC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14135 Ballantyne Corporate PL
Suite 100
Charlotte, NC 28277-3668
Phone (704) 831-4300
550 Mount Holly Medical Pkwy
Belmont, NC 28012-4390
Phone (704) 272-3578
937 Riverwalk Pkwy
Rock Hill, SC 29730-0178
Phone (803) 325-1618
937 Riverwalk Pkwy
Suite 101
Rock Hill, SC 29730-0179
Phone (803) 325-1618
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11520 | SC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrium Health Specialty Network Inc | Physical Therapist | Current | Accepting new patients |
| Carolina Neurosurgery & Spine Associates PA | Current | Accepting new patients | |
| Carolina Neurosurgery & Spine Associates PA | Current | Accepting new patients | |
| Atrium Health Neurospine Network LLC | Current | Accepting new patients | |
| Atrium Health Neurospine Network LLC | Current | Accepting new patients |
Locations
550 Mount Holly Medical Pkwy
Belmont, NC 28012
Phone (704) 272-3578
225 Baldwin Ave
Charlotte, NC 28204
Phone (704) 376-1605
14135 Ballantyne Corporate Pl
Ste 100
Charlotte, NC 28277
Phone (704) 831-4300
9908 Couloak Dr
Ste 100
Charlotte, NC 28216
Phone (704) 801-3065
4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100
110 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 792-2672
937 Riverwalk Pkwy
Ste 101
Rock Hill, SC 29730
Phone (800) 344-6716
937 Riverwalk Pkwy
Rock Hill, SC 29730
Phone (803) 325-1618
Interoperability endpoints
- https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Carolina Neurosurgery & Spine Associates
- Neurological Surgery Physician
- Charlotte, NC
- NPI 1033007695
SC
-
- Neurological Surgery Physician
- Charlotte, NC
- NPI 1154384568
SC
-
dba Atrium Health Dermatology
- Dermatology Physician
- Charlotte, NC
- NPI 1538975636
Physical Therapist
-
dba Carolina Neurosurgery & Spine Associates
- Neurological Surgery Physician
- Rock Hill, SC
- NPI 1831081454
-
- Neurological Surgery Physician
- Rock Hill, SC
- NPI 1548819170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1831818954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BALDWIN AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043109",
"telephone_number": "704-376-1605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 BALDWIN AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043109",
"telephone_number": "704-376-1605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMICO",
"first_name": "MADISON",
"middle_name": "AYERS",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-23",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P21483",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "11520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
- Shana L Dols, LMFTA
- Aaron Matthew Dom, MD
- Kathleen A Doman, M.D.
- Alexander Robert Dombrowsky, MD
- Akosua B. Domfeh, M.D.
- Kenia Dominguez Navarrete, PA-C
- Dominion Health Family Wellness Center
- Marvin Ryan Domondon, D.M.D.
- Maya Domoto, LPC
- Don G. Timpton, D.D.S. & Associates, PA (Carmel Commons Dental)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.