DR. MICHAEL GLENN DOMINA D.O. NPI 1396130613

NPI Information

  • NPI: 1396130613
  • Provider Name: DR. MICHAEL GLENN DOMINA, D.O.
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 740 MIDDLE CREEK RD STE 200
    SEVIERVILLE, TN
    ZIP 37862
  • Phone: (865) 908-9888

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NPI Details

DR. Michael Glenn Domina, D.O. is an obstetrics gynecology in Sevierville, TN with 11 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Michael Glenn Domina, D.O. NPI is 1396130613. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

740 MIDDLE CREEK RD STE 200
SEVIERVILLE, TN
ZIP 37862-056
Phone: (865) 908-9888

The NPI 1396130613 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/2/2015 and was last updated on 12/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyDO213625OREGONNo
2207V00000XObstetrics & GynecologyDO3503MAINENo
3207V00000XObstetrics & GynecologyLT22012MAINENo
4207V00000XObstetrics & Gynecology1630NEBRASKANo
5207V00000XObstetrics & Gynecology5095TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q083566MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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