Individual provider Active NPI

Jill Suzanne Gruber, P.T.

  • Physical Therapist
  • Harrisburg, PA
National Provider Identifier
1194787572
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011396 Issued in OH
Practice address
450 Powers Ave
Lower Level
Harrisburg, PA 17109-5933
Phone
(717) 920-4950
Fax
(717) 920-4955
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 PT015636L PA
Physical Therapist 225100000X PT011396 OH Primary

Addresses

Primary practice location

450 Powers Ave
Lower Level
Harrisburg, PA 17109-5933

Mailing address

4220 Society Park CT
Apt C
Harrisburg, PA 17109-4936
Phone (165) 183-3717

Other identifiers 1

IdentifierTypeStateIssuer
1011115982 0001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219003643 OH Practitioner - Physical Therapist in Private Practice 5193790814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohrh, LLCGroup PAC ID 5991942898, 154 clinicians

Practice addresses (Care Compare)

6021 Cleveland Ave
Columbus, OH 43231-2256
Phone (740) 615-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011396OHMDPhysical Therapist
PT015636LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohrh, LLC Current Accepting new patients
Ohrh, LLC Physical Therapist CurrentSince Nov 1, 2018 Accepting new patients
Ohrh, LLC CurrentSince Nov 1, 2018 Accepting new patients
Orthopedic Surgeons LTD Physical Therapist Past Accepting new patients

Locations

6021 Cleveland Ave
Columbus, OH 43231
Phone (614) 224-1090

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

Organizations & group practices 4

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1194787572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 SOCIETY PARK CT",
            "address_2": "APT C",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094936",
            "telephone_number": "165-183-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 POWERS AVE",
            "address_2": "LOWER LEVEL",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095933",
            "telephone_number": "717-920-4950",
            "fax_number": "717-920-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015636L",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT011396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011115982 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.