Individual provider Active NPI

Jill L Tolley, OTR

  • Occupational Therapist
  • Evansville, IN
National Provider Identifier
1144375577
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31000377A Issued in IN
Practice address
3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone
(812) 479-1411
Fax
(812) 437-2636
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31000377A IN Primary
Ergonomics Occupational Therapist 225XE1200X 31000377A IN
Hand Occupational Therapist 225XH1200X 31000377A IN
Human Factors Occupational Therapist 225XH1300X 31000377A IN
Neurorehabilitation Occupational Therapist 225XN1300X 31000377A IN
Pediatric Occupational Therapist 225XP0200X 31000377A IN
Driving and Community Mobility Occupational Therapist 225XR0403X 31000377A IN

Addresses

Primary practice location

3701 Bellemeade Ave
Evansville, IN 47714-0137

Mailing address

3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone (812) 479-1411

Other identifiers 1

IdentifierTypeStateIssuer
000000218743OtherINANTHEM BC & BS PIN

Other names 1

  • Jill L Weber Former name

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
31000377AINMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1144375577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140137",
            "telephone_number": "812-479-1411",
            "fax_number": "812-437-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140137",
            "telephone_number": "812-479-1411",
            "fax_number": "812-437-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "JILL",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000377A",
            "primary": true
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        },
        {
            "code": "225XH1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Human Factors",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        },
        {
            "code": "225XR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": "IN",
            "license": "31000377A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS PIN",
            "identifier": "000000218743",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "WEBER",
            "middle_name": "L",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

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

Verify at the official NPI Registry.