Individual provider Active NPI

Jill Gridley, C.O.T.A.

  • Occupational Therapy Assistant
  • Beverly, MA
National Provider Identifier
1023318862
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3368 Issued in MA
Practice address
500 Cummings Ctr
Suite 3850
Beverly, MA 01915-6142
Phone
(978) 232-0332
Fax
(978) 232-1103
NPI assigned
Oct 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3368 MA Primary

Addresses

Primary practice location

500 Cummings Ctr
Suite 3850
Beverly, MA 01915-6142

Mailing address

500 Cummings Ctr
Suite 3850
Beverly, MA 01915-6142
Phone (978) 232-0332

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3368MAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1023318862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CUMMINGS CTR",
            "address_2": "SUITE 3850",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156142",
            "telephone_number": "978-232-0332",
            "fax_number": "978-232-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CUMMINGS CTR",
            "address_2": "SUITE 3850",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156142",
            "telephone_number": "978-232-0332",
            "fax_number": "978-232-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDLEY",
        "first_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "C.O.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "3368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.