Active NPI
Eileen Marie O'Connell, PT
- Physical Therapist
- Oaklyn, NJ
National Provider Identifier
1689852980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00803400
- Practice address
- 215 W Clinton Ave
Suite 103
Oaklyn, NJ 08107-1500 - Phone
- (215) 498-6056
- NPI assigned
- Feb 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 40QA00803400 | NJ | Primary |
Addresses
Primary practice location
215 W Clinton Ave
Suite 103
Oaklyn, NJ 08107-1500
Mailing address
215 W Clinton Ave
Suite 103
Oaklyn, NJ 08107-1500
Phone (215) 498-6056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00803400 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Grove Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
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
- Willow Grove, PA
- NPI 1083659783
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202428800000",
"number": "1689852980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W CLINTON AVE",
"address_2": "SUITE 103",
"city": "OAKLYN",
"state": "NJ",
"postal_code": "081071500",
"telephone_number": "215-498-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W CLINTON AVE",
"address_2": "SUITE 103",
"city": "OAKLYN",
"state": "NJ",
"postal_code": "081071500",
"telephone_number": "215-498-6056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNELL",
"first_name": "EILEEN",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-08",
"last_updated": "2008-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00803400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oaklyn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.