Individual provider Active NPI

Corrinne Marie O'Neill

  • Occupational Therapist
  • Chesapeake, VA
National Provider Identifier
1093964488
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119004945 Issued in VA
Practice address
1100 Volvo Pkwy Ste 320
Chesapeake, VA 23320-3341
Phone
(757) 606-0531
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119004945 VA Primary

Addresses

Primary practice location

1100 Volvo Pkwy Ste 320
Chesapeake, VA 23320-3341

Mailing address

7526 Valley Circle LN
Hamburg, NY 14075-6821
Phone (716) 648-9211

Other practice location 1

7526 Valley Circle Ln
Hamburg, NY 14075-6821
Phone (716) 648-9211

Other names 1

  • Corrinne Marie Deroller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106001094 VA Practitioner - Occupational Therapist in Private Practice 5395115406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kiernan Speech Therapy LLCGroup PAC ID 4183903677, 3 clinicians

Practice addresses (Care Compare)

1100 Volvo Pkwy
Suite 320
Chesapeake, VA 23320-3341
Phone (757) 606-0531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kiernan Speech Therapy LLC CurrentSince Sep 30, 2022 Accepting new patients

Locations

1100 Volvo Pkwy
Ste 320
Chesapeake, VA 23320
Phone (757) 606-0531

Organizations & group practices 1

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1093964488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7526 VALLEY CIRCLE LN",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756821",
            "telephone_number": "716-648-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VOLVO PKWY STE 320",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203341",
            "telephone_number": "757-606-0531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7526 Valley Circle Ln",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "NY",
            "postal_code": "140756821",
            "country_code": "US",
            "telephone_number": "716-648-9211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "CORRINNE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRINNE",
            "last_name": "DEROLLER",
            "middle_name": "MARIE",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.