DR. CRISPIN RABARA DOMINGO JR. (NPI# 1043354376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043354376 |
| Entity Type | Individual |
| Full Name | DR. CRISPIN RABARA DOMINGO JR. |
| Credential | M.D. |
| Practice Address |
4801 Veterans Dr Saint Cloud MN 56303-2015 |
| Practice Telephone | 3202521670 |
| Practice Fax Number | 3203556359 |
| Mailing Telephone | 3202521670 |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2014-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 49398 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
4801 VETERANS DR |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780675629 | Michelle P Pittman-leyendecker | Nurse Practitioner | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2005-10-31 |
| 1255939773 | Samantha Stager | Registered Nurse | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-10-16 |
| 1447866587 | Alyssa L Pumford | Dietitian, Registered | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-09-22 |
| 1427663905 | John David Estep | Social Worker | 4801 Veterans Dr, B28 Rm 155, Saint Cloud, MN 56303-2099 | 2020-09-11 |
| 1962012823 | Kelly A Pittman | Social Worker | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-05 |
| 1356951297 | Alyssa Anne Berscheid | Registered Nurse | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-05 |
| 1790395861 | Anna Elisabeth Lee | Dietitian, Registered | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-04 |
| 1932718004 | Bradee Schiefelbein | Audiologist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-07-24 |
| 1346865532 | Kali Rae Pichotta | Nurse Practitioner | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-06-12 |
| 1174145783 | Renae Elizabeth Lockerby | Social Worker | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1851825343 | Adventist Health System/sunbelt, Inc. | Family Medicine | 4660 13th St, Saint Cloud, FL 34769-6765 | 2017-04-12 |
| 1871045377 | Anthony Joseph Picconatto | Family Medicine | 1900 Centracare Cir Ste 1450, Saint Cloud, MN 56303-5000 | 2016-10-31 |
| 1093195489 | Olufunke O Ajayi | Family Medicine | Centracare Clinic St Cloud Medical Group South, 1301 33rd St S, Saint Cloud, MN 56301-9668 | 2015-06-01 |
| 1417180043 | Premier Life Health Services, LLC | Family Medicine | 4737 Old Canoe Creek Road, Saint Cloud, FL 34769-0000 | 2009-08-31 |
| 1023269438 | Elba Ener Masid | Family Medicine | 4513 Old Canoe Creek Rd, Saint Cloud, FL 34769-1551 | 2008-10-03 |
| 1124211164 | Access Pronto Family Medicine P A | Family Medicine | 2918 17th St, Saint Cloud, FL 34769-6018 | 2007-08-23 |
| 1205856705 | Ahmed Quaye Aidoo | Family Medicine | 3501 13th St, Saint Cloud, FL 34769-4054 | 2006-07-20 |
| 1437106986 | Clarice Hanks Konshok | Family Medicine | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2006-05-30 |
| 1811949415 | Carmen Ana Sierra | Family Medicine | 4741 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | 2006-05-16 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.