Individual provider Active NPI

Jill Ivory Collins, MSPT

  • Pediatric Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1003491481
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT24732 Issued in FL
Practice address
14421 Metropolis Ave Ste 103
Fort Myers, FL 33912-4323
Phone
(239) 561-2778
Fax
(239) 561-8107
NPI assigned
Mar 16, 2021
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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 PT24732 FL
Pediatric Physical Therapist 2251P0200X PT24732 FL Primary

Addresses

Primary practice location

14421 Metropolis Ave Ste 103
Fort Myers, FL 33912-4323

Mailing address

10160 Bellavista Cir Apt 1201
Miromar Lakes, FL 33913-8983
Phone (586) 634-5695

Other identifiers 1

IdentifierTypeStateIssuer
109944800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250918001575 FL Practitioner - Physical Therapist in Private Practice 0749784197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 2147
Fort Myers, FL 33902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24732FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Aug 1, 2025 Accepting new patients
Lee Health System Inc Single Specialty CurrentSince Aug 1, 2025 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

3361 Pine Ridge Rd
Ste 105
Naples, FL 34109
Phone (239) 254-4260

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1003491481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10160 BELLAVISTA CIR APT 1201",
            "city": "MIROMAR LAKES",
            "state": "FL",
            "postal_code": "339138983",
            "telephone_number": "586-634-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14421 METROPOLIS AVE STE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124323",
            "telephone_number": "239-561-2778",
            "fax_number": "239-561-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JILL",
        "middle_name": "IVORY",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24732",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT24732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109944800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.