Individual provider Active NPI

Sara O'Donnell, DPT

  • Physical Therapist
  • Davenport, IA
National Provider Identifier
1073248381
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
115850 Issued in IA
Practice address
6101 Northwest Blvd
Davenport, IA 52806-1861
Phone
(563) 322-0971
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 115850 IA Primary
Physical Therapist 225100000X 070026485 IL

Addresses

Primary practice location

6101 Northwest Blvd
Davenport, IA 52806-1861

Mailing address

2300 53Rd Ave Ste 100
Bettendorf, IA 52722-7565
Phone (563) 322-0971

Other practice location 1

2300 53rd Ave Ste Ll02
Bettendorf, IA 52722-7565
Phone (563) 449-7000

Other practice location 2

510 Valley View Dr
Moline, IL 61265-6133
Phone (309) 797-0866

Other identifiers 2

IdentifierTypeStateIssuer
070026485OtherILLICENSE
115850OtherIALICENSE

Other names 1

  • Sara Hipsman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221006002715 IL Practitioner - Physical Therapist in Private Practice 4183000672 Reassigns benefits to 1 organization
I20221019002038 IA Practitioner - Physical Therapist in Private Practice 4183000672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ora Orthopedics PCGroup PAC ID 6406741784, 119 clinicians

Practice addresses (Care Compare)

510 Valley View Dr
Moline, IL 61265-6133
Phone (309) 762-3621

6101 Northwest Blvd
Davenport, IA 52806-1861
Phone (563) 322-0971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070026485ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ora Orthopedics PC CurrentSince Sep 26, 2022 Accepting new patients
Ora Orthopedics, PC CurrentSince Sep 26, 2022 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

2300 53rd Ave
Ste 100
Bettendorf, IA 52722
Phone (563) 459-4005

2300 53rd Ave
Ste LL02
Bettendorf, IA 52722
Phone (563) 332-4422

2300 53rd Ave
Ste LL04
Bettendorf, IA 52722

1414 W Lombard St
Davenport, IA 52804
Phone (563) 326-6431

6101 Northwest Blvd
Davenport, IA 52806
Phone (563) 449-7004

510 Valley View Dr
Moline, IL 61265
Phone (309) 762-3621

520 Valley View Dr
Moline, IL 61265
Phone (309) 762-1952

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1073248381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 53RD AVE STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227565",
            "telephone_number": "563-322-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 NORTHWEST BLVD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528061861",
            "telephone_number": "563-322-0971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 53rd Ave Ste Ll02",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527227565",
            "country_code": "US",
            "telephone_number": "563-449-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656133",
            "country_code": "US",
            "telephone_number": "309-797-0866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "SARA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "115850",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070026485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "070026485",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "115850",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "HIPSMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.