TIM D DOMINICK (NPI# 1033536354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033536354 |
| Entity Type | Individual |
| Full Name | TIM D DOMINICK |
| Credential | PA-C |
| Practice Address |
1400 Johnston Willis Dr Ste A North Chesterfield VA 23235-4765 |
| Mailing Address |
1115 Boulders Pkwy Ste 200 North Chesterfield VA 23225-4067 |
| Practice Telephone | 8043798088 |
| Mailing Telephone | 8045605595 |
| Mailing Fax Number | 8045609029 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2085 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | 0110-006707 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1400 JOHNSTON WILLIS DR STE A |
| City | NORTH CHESTERFIELD |
| State | VA |
| Zip Code | 23235-4765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831719301 | Jasper Kyle Coleman | Physical Therapist | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235-4765 | 2020-04-24 |
| 1780142190 | Christopher Karaffa | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235-4765 | 2019-03-05 |
| 1861961443 | James A Luker | Physical Therapist | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235-4765 | 2018-11-13 |
| 1245711340 | Rachel E. J Shields | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-08-27 |
| 1710486931 | Emily Nilson | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275770 | Melani Jones | Social Worker | 10825 Midlothian Turnpike Ste 201r, Richmond, VA 23235 | 2020-08-12 |
| 1447880109 | Sara Hudson | Pharmacist | 2821 Hicks Rd, North Chesterfield, VA 23235 | 2020-01-22 |
| 1730729096 | Mary Tabitha Varney | Counselor | 101 Buford Rd. Unit 110, North Chesterfield, VA 23235 | 2020-01-14 |
| 1093355133 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2015 Huguenot Road, North Chesterfield, VA 23235 | 2020-01-07 |
| 1255975983 | Louise Rutledge | Psychiatry & Neurology | 1429 Buford Rd, N. Chesterfield, VA 23235 | 2019-11-06 |
| 1114489317 | Therapeutic Learning Consortium LLC | Counselor | 8154 Forest Hill Ave Ste 2, North Chesterfield, VA 23235 | 2019-04-05 |
| 1013400332 | Shawmika Wright | Social Worker | 1301 Whitehead Road, Richmond, VA 23235 | 2018-06-11 |
| 1912490608 | Cara Whiting | Physical Therapist | 1400 Johnston Willis Dr Ste B, North Chesterfield, VA 23235 | 2018-06-07 |
| 1003324682 | David E Fortin | Hearing Instrument Specialist | 10441 Midlothian Turnpike, Richmond, VA 23235 | 2018-01-17 |
| 1053836544 | Hannah Katherine Chisholm | Physical Therapist | 1400 Johnston-willis Drive, Richmond, VA 23235 | 2017-08-07 |
| Find all providers in zip 23235 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245581677 | Nicole Michelle Kellner | Physician Assistant | 9460 Amberdale Dr Ste D, North Chesterfield, VA 23236-1259 | 2012-09-25 |
| 1790875698 | Jennifer Diane Bauer | Physician Assistant | 10800 Midlothian Tpke Ste 309, North Chesterfield, VA 23235 | 2006-10-13 |
| 1215969100 | Elizabeth F. Hensley | Physician Assistant | 1000 Boulders Pkwy Ste 101, North Chesterfield, VA 23225-5515 | 2006-07-07 |
| 1538104138 | Johnathon Chisum | Physician Assistant | 1115 Boulders Pkwy Ste 100, North Chesterfield, VA 23225-4067 | 2006-06-18 |
| 1780142190 | Christopher Karaffa | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235-4765 | 2019-03-05 |
| 1770041188 | Kiersten Nicole Basciano | Physician Assistant | 1051 Johnston Willis Dr Ste 200, North Chesterfield, VA 23235-4871 | 2019-03-05 |
| 1245711340 | Rachel E. J Shields | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-08-27 |
| 1710486931 | Emily Nilson | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-02-02 |
| 1639616097 | William Bader | Physician Assistant | 1400 Johnston Willis Dr, Suite A, North Chesterfield, VA 23235-4765 | 2017-01-24 |
| 1750826004 | Rachel Lynn Kobeski | Physician Assistant | 2602 Buford Rd, North Chesterfield, VA 23235-3422 | 2016-12-22 |
| Find all providers in NORTH CHESTERFIELD | ||||
| City | NORTH CHESTERFIELD |
| Zip Code | 23235 |
Please comment or provide details below to improve the information on TIM D DOMINICK.
| 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.