Individual provider Active NPI

Laney Virginia O'Neill, MPT

  • Physical Therapist
  • Des Moines, WA
National Provider Identifier
1104933951
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9074 Issued in WA
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

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20090826000920 WA Practitioner - Physical Therapist in Private Practice 8123173127 Reassigns benefits to 1 organization

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
Wellspring Physical Therapy Services P SGroup PAC ID 8224326657, 5 clinicians

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

LicenseStateTypeSpecialty
9074WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Physical Therapy Services PS CurrentSince Jun 16, 2016 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.

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.

Verify at the official NPI Registry.