DR. MARK DOMAAS (NPI# 1265845010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265845010 |
Entity Type | Individual |
Full Name | DR. MARK DOMAAS |
Credential | DPM |
Practice Address |
4450 31st Ave S Ste 102 Fargo ND 58104-4557 |
Mailing Address |
4450 31st Ave S Ste 102 Fargo ND 58104-4557 |
Practice Telephone | 7015668721 |
Practice Fax Number | 7012054593 |
Mailing Telephone | 7015613312 |
Mailing Fax Number | 7012325578 |
Enumeration Date | 2014-06-10 |
Last Update Date | 2020-04-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213E00000X | Podiatrist | 016005716 | IL | Podiatric Medicine & Surgery Service Providers |
Y | 213E00000X | Podiatrist | 82 | ND | Podiatric Medicine & Surgery Service Providers |
Street Address |
4450 31ST AVE S STE 102 |
City | FARGO |
State | ND |
Zip Code | 58104-4557 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396184859 | Nicholas Steven Adams | Plastic Surgery | 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557 | 2013-06-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
Find all providers in zip 58104 |
Taxonomy Code | 213E00000X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114453552 | Derek Anthony Mclister | Podiatrist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2017-05-04 |
1255505004 | A Foot Doctor, Pllc | Podiatrist | 2631 12th Ave S, Fargo, ND 58103-8741 | 2008-04-14 |
1649298381 | Brad C Anderson | Podiatrist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2006-07-18 |
1902824600 | Richard E Arness | Podiatrist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2006-07-18 |
1972534642 | Lee A Hofsommer | Podiatrist | 1702 University Dr S, Fargo, ND 58103-4940 | 2006-07-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902933401 | Richard Gary Mason | Podiatrist | 3883 74th St. N.e., 3883 74th St. N.e., Fort Totten, ND 58335-0309 | 2007-02-28 |
1942341086 | Nathan Richard Randall | Podiatrist | 1 Main Hospital Road, Box 160, Belcourt, ND 58316-0160 | 2007-02-10 |
1386654424 | Jessica Anne Bentson | Podiatrist | 525 N 9th St, Bismarck, ND 58501-4510 | 2006-08-09 |
1336173871 | Basem Fanous | Podiatrist | Hwy 281n, Cando, ND 58324-0688 | 2006-07-10 |
1518965276 | Cherian Mathew | Podiatrist | 2215 Sims St, Dickinson, ND 58601-6521 | 2005-07-07 |
1992206528 | Elbowoods Memorial Health Center | Podiatrist | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
1184010969 | Adam Finzen | Podiatrist | 4440 S Washington St - Altru Professional Center, Grand Froks, ND 58201-7245 | 2015-04-08 |
1659788164 | Kayla Marie Emter | Podiatrist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2014-07-16 |
1407111321 | Andrew Dean Knudsen | Podiatrist | 401 N 9th St, Bismarck, ND 58501-4530 | 2012-07-06 |
1326306630 | Burkley Jensen | Podiatrist | 300 N 7th St, Bismarck, ND 58501 | 2012-04-25 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.