TERRY GAYLE DOMINO


Address: 1835 West County Road C, Roseville, MN 55113-1304
Phone: 7637854300

TERRY GAYLE DOMINO (NPI# 1396727988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396727988
Entity Type Individual
Full Name TERRY GAYLE DOMINO
Credential MD
Practice Address 1835 West County Road C
Roseville
MN 55113-1304
Practice Telephone 7637854300
Practice Fax Number 7637853314
Mailing Telephone 7637854300
Mailing Fax Number 7637853314
Enumeration Date 2005-11-18
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 22141 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 33858500C 05

Other Providers TERRY DOMINO

NPI Name Taxonomy Address Enumeration
1598283087 Terry Domino Social Worker 4300 S I 10 Service Rd W Ste 215, Metairie, LA 70001-7436 2017-09-05

Office Location

Street Address 1835 WEST COUNTY ROAD C
City ROSEVILLE
State MN
Zip Code 55113-1304

Providers in the same location

NPI Name Taxonomy Address Enumeration
1487623435 Cheryl Marie Klenow Preventive Medicine 1835 West County Road C, Roseville, MN 55113-1304 2006-03-14
1750365904 Sheila Anne Flynn Family Medicine 1835 West County Road C, Roseville, MN 55113-1304 2005-12-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396384376 Zachary Mattson Physician Assistant Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 2019-12-23
1467010330 Ahmed Issa Student in an Organized Health Care Education/Training Program 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 2019-06-05
1821653833 Suite Living Senior Care of Little Canada Assisted Living Facility 2740 Rice Street, Little Canada, MN 55113 2019-05-06
1902370505 Diverse Assessments and Treatment, LLC Psychologist 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 2019-01-16
1588138473 Applewood Home Health Care, LLC Home Health 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 2019-01-14
1699251520 Optum Infusion Services 500, Inc. Durable Medical Equipment & Medical Supplies 2685 Patton Rd, Roseville, MN 55113 2018-07-13
1083104145 Suite Living Senior Care of Roseville Assisted Living Facility 197 County Road B2 W, Roseville, MN 55113 2018-05-15
1477055796 Sunrise Residential Services LLC Home Health 216 Maple Ln, Roseville, MN 55113 2018-03-02
1194223024 Alissa Hoff Specialist 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 2018-01-25
1841705118 Kingsland Care Services Incorporated Case Management 2301 Rice Street, Suite 101, Roseville, MN 55113 2017-12-08
Find all providers in zip 55113

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154711299 Shahzad Anwar Md Inc Family Medicine 1478 Stone Point Dr # 290, Roseville, CA 95661-2869 2015-01-28
1902162845 Stephanie Wood Family Medicine 568 N. Sunrise Avenue, Suite 250, Roseville, CA 95661-9348 2012-04-04
1467740696 Gilbert R Luceno Family Medicine 2110 Professional Dr Ste 120, Roseville, CA 95661-3779 2011-07-21
1255620936 Nancy Kemp Family Medicine 3009 Douglas Blvd, Suite 160, Roseville, CA 95661-3859 2011-04-01
1649586694 Anna P Abalos Md Inc Family Medicine 701 Pleasant Grove Blvd, Suite 125, Roseville, CA 95678-6156 2010-08-27
1528389145 Shahzad Anwar Family Medicine 1478 Stone Point Dr, Suite 290, Roseville, CA 95661-2869 2010-06-17
1740424480 Diana Libertad Arteaga Falconi Family Medicine 2110 Professional Drive, Suite 120, Roseville, CA 95661 2009-04-24
1912144593 Jennifer Anne Griffin Family Medicine 8 Medical Plaza Dr, Roseville, CA 95661-3106 2009-01-19
1922263151 Erin M. Deane Family Medicine 568 N. Sunrise Ave., #250, Roseville, CA 95661 2008-07-28
1669655627 Nine Family Healthcare Family Medicine 18263 E 10 Mile Rd Ste C, Roseville, MI 48066-5805 2007-12-13
Find all providers in ROSEVILLE

Competitor

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City ROSEVILLE
Zip Code 55113

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Dataset Information

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.

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