Dominique Madeleine Kohlenberger, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 7196 Issued in FL

Practice address

4134 Gulf of Mexico Dr
Unit 209
Longboat Key, FL 34228-2642

Phone

(941) 383-0414

Fax

(941) 383-0120

NPI assigned

Jan 4, 2012

Last updated

Jan 4, 2012By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1992075279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1156",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342221156",
            "telephone_number": "941-729-0003",
            "fax_number": "941-729-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4134 GULF OF MEXICO DR",
            "address_2": "UNIT 209",
            "city": "LONGBOAT KEY",
            "state": "FL",
            "postal_code": "342282642",
            "telephone_number": "941-383-0414",
            "fax_number": "941-383-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLENBERGER",
        "first_name": "DOMINIQUE",
        "middle_name": "MADELEINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 7196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Longboat Key, FL
• Providers in Longboat Key, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.