Individual provider Active NPI

Ian P McDonnell, DPT

  • Physical Therapist
  • Chesterfield, MO
National Provider Identifier
1841916665
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022030884 Issued in MO
Practice address
14825 N Outer 40 Rd Ste 300
Chesterfield, MO 63017-0002
Phone
(636) 812-1211
Fax
(636) 812-0159
NPI assigned
Oct 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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 2022030884 MO Primary

Addresses

Primary practice location

14825 N Outer 40 Rd Ste 300
Chesterfield, MO 63017-0002

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017002536 MO Practitioner - Physical Therapist in Private Practice 9133595176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
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

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
2022030884MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 4, 2022 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 4, 2022 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

14825 North Outer 40 Rd
Ste 300
Chesterfield, MO 63017
Phone (636) 581-2121

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

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

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

Interoperability endpoints

  • Direct secure messaging: ian.mcdonnell.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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1841916665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD STE 300",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170002",
            "telephone_number": "636-812-1211",
            "fax_number": "636-812-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "IAN",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022030884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.