DOUGLASS T. DOMOTO, M.D., J.D., P.C. (NPI# 1124337373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124337373 |
| Entity Type | Organization |
| Organization Name | DOUGLASS T. DOMOTO, M.D., J.D., P.C. |
| Practice Address |
2606 Clark Ave Ave Saint Louis MO 63103-2502 |
| Mailing Address |
2606 Clark Ave Saint Louis MO 63103-2502 |
| Practice Telephone | 3145353720 |
| Practice Fax Number | 3145357391 |
| Mailing Telephone | 3145353720 |
| Mailing Fax Number | 3145357391 |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-10-05 |
| Authorized Official Name | DR. DOUGLASS TAKASHI DOMOTO (PRESIDENT) |
| Authorized Official Telephone | 3145353720 |
| Authorized Official Credential | M.D., J.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
R6C21 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
2606 CLARK AVE AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63103-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588764724 | Douglass Takashi Domoto | Internal Medicine | 2606 Clark Ave, Saint Louis, MO 63103-2502 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306355045 | Dimensions of Care | Home Health | 1911washington Ave, Saint Louis, MO 63103 | 2017-09-26 |
| 1467972752 | Rebecca Jones | Social Worker | 1430 Olive Street, 500, St. Louis, MO 63103 | 2017-06-27 |
| 1780124511 | Priority Consumer Directed Services LLC | Home Health | 1409 Washintong Ave, Suite 504, Saint Louis, MO 63103 | 2017-02-27 |
| 1437562766 | Lindsey's Stepping Stones LLC | In Home Supportive Care | 1409 Washibgton Ave Suite 208, Saint Louis, MO 63103 | 2014-06-04 |
| 1952711046 | Jonathan Burch | Specialist/Technologist | 3330 Laclede Avenue, Saint Louis University - Chaifetz Arena, Saint Louis, MO 63103 | 2014-04-29 |
| 1912329954 | Chanel Mitchell | Social Worker | 1430 Olive, Suite 500, Saint Louis, MO 63103 | 2014-01-10 |
| 1194067116 | Hassan R Jafri | Physical Therapist | 1722 Olive, Sutie 201, St. Louis, MO 63103 | 2013-03-18 |
| 1710240023 | Dorothy Harris | Licensed Practical Nurse | 615 North Grand, Saint Louis, MO 63103 | 2012-06-21 |
| 1932407335 | Terence Michael Crowley | Chiropractor | 3141 Locust St Ste 200, Saint Louis, MO 63103 | 2011-03-09 |
| 1104123470 | Thompson Home Health Team LLC | Chore Provider | 3101 Olive Street, St Louis, MO 63103 | 2011-02-22 |
| Find all providers in zip 63103 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033649819 | Taewoo Lee | Internal Medicine | 3635 Vista Ave Saint Louis University Medical Center, Division of Nephrology, Saint Louis, MO 63110 | 2017-06-14 |
| 1780058727 | St Louis Kidney Care LLC | Internal Medicine | 11155 Dunn Rd Ste 211n, Saint Louis, MO 63136-6166 | 2015-11-13 |
| 1184056830 | Ralph Robert Hatlelid | Internal Medicine | 318 E Swon Ave, Saint Louis, MO 63119-3112 | 2013-08-05 |
| 1497000194 | Siddiq Anwar | Internal Medicine | 660 S Euclid Ave # 8129, Renal Fellowship Program, Saint Louis, MO 63110-1010 | 2012-07-18 |
| 1588764724 | Douglass Takashi Domoto | Internal Medicine | 2606 Clark Ave, Saint Louis, MO 63103-2502 | 2006-09-25 |
| 1699708016 | Bhajanlal S Dara | Internal Medicine | 10160 W Florissant Ave, Suite 200, Saint Louis, MO 63136-2104 | 2006-07-09 |
| 1962432807 | Guner Buyukkus Gulmen | Internal Medicine | 100 N Euclid Ave, Suite 800, Saint Louis, MO 63108-1529 | 2006-07-04 |
| 1710920947 | Rajalakshmi T Gopalakrishnan | Internal Medicine | 915, North Grand Boulevard, Saint Louis, MO 63106 | 2006-06-14 |
| 1457348286 | Kira S Mailey | Internal Medicine | 18 Chapel Hill Est, Saint Louis, MO 63131-1315 | 2005-10-06 |
| 1376166066 | Nhs South LLC | Internal Medicine | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2020-05-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63103 |
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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.