Individual provider Active NPI

Shannon Marie O'Neal, PT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1568523520
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1172030 Issued in TX
Practice address
5950 Bryant Irvin Rd
Suite 200
Fort Worth, TX 76132-4210
Phone
(817) 294-4646
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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 1172030 TX Primary

Addresses

Primary practice location

5950 Bryant Irvin Rd
Suite 200
Fort Worth, TX 76132-4210

Mailing address

3070 Bellaire Ranch Dr Apt 614
Fort Worth, TX 76109-1824
Phone (817) 319-2930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070531000566 TX Practitioner - Physical Therapist in Private Practice 4688772569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Rehab Center IncGroup PAC ID 6800989369, 123 clinicians

Practice addresses (Care Compare)

6407 Southwest Blvd
Benbrook, TX 76132-2777
Phone (817) 423-5611

Merit-based Incentive Payment System (MIPS)

Final score
74.64 of 100Reported as group
Quality
46.1
Promoting interoperability
92
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Rehab Center Inc Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients
Endeavor Rehab Center Inc Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients

Locations

6911 Ranch Road 620 N
Austin, TX 78732
Phone (512) 219-8533

6407 Southwest Blvd
Benbrook, TX 76132
Phone (817) 423-5611

5632 Edwards Ranch Rd
Ft Worth, TX 76109
Phone (817) 259-0600

896 Summit St
Round Rock, TX 78664
Phone (512) 599-4262

Organizations & group practices 2

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1568523520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 BELLAIRE RANCH DR APT 614",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091824",
            "telephone_number": "817-319-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 BRYANT IRVIN RD",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324210",
            "telephone_number": "817-294-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1172030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.