Active NPI
Laney Virginia O'Neill, MPT
- Physical Therapist
- Des Moines, WA
National Provider Identifier
1104933951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9074
- Practice address
- 22659 Pacific Hwy S
Suite 201
Des Moines, WA 98198-5155 - Phone
- (206) 824-3668
- Fax
- (206) 824-3964
- NPI assigned
- Aug 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9074 | WA | Primary |
Addresses
Primary practice location
22659 Pacific Hwy S
Suite 201
Des Moines, WA 98198-5155
Mailing address
33650 6TH Ave S Ste 100
Federal Way, WA 98003-6754
Phone (253) 942-3308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
33650 6TH Ave S
Federal Way, WA 98003-6754
Phone (253) 942-3308
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9074 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspring Physical Therapy Services PS | Current | Accepting new patients |
Locations
33650 6th Ave S
Ste 114
Federal Way, WA 98003
Phone (253) 942-3308
33650 6th Ave S
Ste 100
Federal Way, WA 98003
Phone (253) 942-3303
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.
-
- Physical Therapy Clinic/Center
- Federal Way, WA
- NPI 1891240255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1104933951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33650 6TH AVE S STE 100",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036754",
"telephone_number": "253-942-3308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22659 PACIFIC HWY S",
"address_2": "SUITE 201",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981985155",
"telephone_number": "206-824-3668",
"fax_number": "206-824-3964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "LANEY",
"middle_name": "VIRGINIA",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "9074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.