Individual provider Active NPI

Dawn M Mansfield

  • Physical Therapist
  • Rockford, IL
National Provider Identifier
1528480241
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.004473 Issued in IL
Practice address
6451 East Riverside Blvd
Suite 103
Rockford, IL 61114
Phone
(815) 639-9900
NPI assigned
Jan 15, 2014
Last updated
Jan 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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 070.004473 IL Primary
Massage Therapist 225700000X 227.015797 IL

Addresses

Primary practice location

6451 East Riverside Blvd
Suite 103
Rockford, IL 61114

Mailing address

6451 E. Riverside Blvd.
#103
Rockford, IL 61114
Phone (815) 639-9900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140519001113 IL Practitioner - Physical Therapist in Private Practice 0648493775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cevene Care Clinic IncGroup PAC ID 0446208458, 4 clinicians

Practice addresses (Care Compare)

6451 E Riverside Blvd
Suite 103
Rockford, IL 61114-4402
Phone (815) 639-9900

6451 E Riverside Blvd
Suite 103
Rockford, IL 61114-4421

Merit-based Incentive Payment System (MIPS)

Final score
85.1 of 100Reported as group
Quality
95
Promoting interoperability
82
Improvement activities
40
Cost
70.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.004473ILMDPhysical Therapist
227.015797ILMDMassage Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1528480241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 E. RIVERSIDE BLVD.",
            "address_2": "#103",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "815-639-9900",
            "fax_number": "815-639-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 EAST RIVERSIDE BLVD",
            "address_2": "SUITE 103",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "815-639-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "DAWN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.004473",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.015797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.