Individual provider Active NPI

Donald Thorsen

  • Occupational Therapist
  • O Fallon, MO
National Provider Identifier
1770930463
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2016017355 Issued in IL
Practice address
951 Waterbury Falls Dr
O Fallon, MO 63368-2202
Phone
(636) 336-0297
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2016017355 IL Primary

Addresses

Primary practice location

951 Waterbury Falls Dr
O Fallon, MO 63368-2202

Mailing address

600 Oakmont LN
Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712000498 MO Practitioner - Occupational Therapist in Private Practice 2567754591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

14825 N Outer 40 Rd
Suite 300
Chesterfield, MO 63017-0002
Phone (636) 812-1211

1832 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 327-7110

951 Waterbury Falls Dr
O Fallon, MO 63368-2202
Phone (636) 336-0300

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016017355ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD CurrentSince Jun 24, 2020 Accepting new patients
Athletico LTD Occupational Therapist Current Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Jun 24, 2020 Accepting new patients

Locations

1047 Century Dr
Edwardsville, IL 62025
Phone (618) 307-3434

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

951 Waterbury Falls Dr
O Fallon, MO 63368
Phone (636) 336-0300

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

107 Concord Plaza Shopping Ctr
Saint Louis, MO 63128
Phone (314) 842-2990

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: donald.thorsen.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1770930463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN",
            "address_2": "STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 WATERBURY FALLS DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682202",
            "telephone_number": "636-336-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSEN",
        "first_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "2016017355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.