Dominique Joseph Byrd, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31002239A Issued in IN

Practice address

1062 Springwater Rd
Kokomo, IN 46902-4899

Phone

(765) 776-6309

NPI assigned

Nov 5, 2007

Last updated

Nov 5, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in IN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Merrillville, IN
  • NPI 1053833657

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1902086176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 SPRINGWATER RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024899",
            "telephone_number": "765-776-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 SPRINGWATER RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024899",
            "telephone_number": "765-776-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "DOMINIQUE",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31002239A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "31002239A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin James Buszek, MD
• Samantha Marie Buszek
• Kennedy Christine Butler, RBT
• Shannon Elizabeth Butts
• Heather Bye, NP
• Kimberly Sue Byrum
• C Hammerly Anesthesia Services LLC
• C W Bartholomew, DDS, PC
• Julie M Caldwell Harrell, LCSW
• James Calhoun

• Occupational Therapist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.