Active NPI
Dominic Lee Di Manna, ATC-R
- Athletic Trainer
- Lakewood, CO
National Provider Identifier
1891128625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 666
- Practice address
- 13253 W Utah Cir
Lakewood, CO 80228-4227 - Phone
- (303) 912-4530
- NPI assigned
- Aug 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 666 | CO | Primary |
Addresses
Primary practice location
13253 W Utah Cir
Lakewood, CO 80228-4227
Mailing address
13253 W Utah Cir
Lakewood, CO 80228-4227
Phone (303) 912-4530
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 666 | CO | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376524800000",
"number": "1891128625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13253 W UTAH CIR",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802284227",
"telephone_number": "303-912-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13253 W UTAH CIR",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802284227",
"telephone_number": "303-912-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DI MANNA",
"first_name": "DOMINIC",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "ATC-R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-15",
"last_updated": "2013-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.