Individual provider Active NPI

Devon Rae Oneill, DPT

  • Physical Therapist
  • Wolcott, CT
National Provider Identifier
1265720882
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009154 Issued in CT
Practice address
465 Wolcott Rd
Wolcott, CT 06716-2613
Phone
(203) 879-0107
Fax
(203) 879-0206
NPI assigned
Jul 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 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 009154 CT Primary

Addresses

Primary practice location

465 Wolcott Rd
Wolcott, CT 06716-2613

Mailing address

465 Wolcott Rd
Wolcott, CT 06716-2613
Phone (203) 879-0107

Other names 1

  • Devon Rae Dougherty Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110808000518 CT Practitioner - Physical Therapist in Private Practice 9133398209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rvnahealth, IncGroup PAC ID 7416990569, 29 clinicians

Practice addresses (Care Compare)

27 Governor St
Ridgefield, CT 06877-4657
Phone (203) 438-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009154CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rvnahealth, Inc. CurrentSince May 1, 2022 Accepting new patients
Rvnahealth, Inc. CurrentSince May 1, 2022 Accepting new patients
Community Physical Therapy Physical Therapist PastSince Oct 1, 2014 Accepting new patients

Locations

27 Governor St
Ridgefield, CT 06877
Phone (203) 438-5555

Organizations & group practices 4

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": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1265720882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162613",
            "telephone_number": "203-879-0107",
            "fax_number": "203-879-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162613",
            "telephone_number": "203-879-0107",
            "fax_number": "203-879-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEILL",
        "first_name": "DEVON",
        "middle_name": "RAE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-17",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVON",
            "last_name": "DOUGHERTY",
            "middle_name": "RAE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wolcott, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.