Jan Dommerholt, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16428 Issued in MD

Practice address

7830 Old Georgetown Rd
Suite C-15
Bethesda, MD 20814-2432

Phone

(301) 656-5613

Fax

(301) 656-6586

NPI assigned

Feb 21, 2007

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

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethesda PhysiocareGroup PAC ID 6305929993, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bethesda Physiocare

  • Physical Therapist
  • Bethesda, MD
  • NPI 1245437318

  DC

  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1841335007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 OLD GEORGETOWN RD",
            "address_2": "SUITE C-15",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142432",
            "telephone_number": "301-656-5613",
            "fax_number": "301-656-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 OLD GEORGETOWN RD",
            "address_2": "SUITE C-15",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142432",
            "telephone_number": "301-656-5613",
            "fax_number": "301-656-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMMERHOLT",
        "first_name": "JAN",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Dombrowsky, LMSW
• Madeleine N Domenech, DDS
• Ana Sofia Domingues, O.D.
• Jose E Dominguez, M.D.
• Kate P Dominguez
• Douglas Dompkowski, D.D.S
• Kristen Donahoe, SLP
• Stephanie Donahoe, RPH, MPH
• Katherine Donahue
• Brian Donaldson, MD

• Physical Therapist in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.

Verify at the official NPI Registry.