Individual provider Active NPI

Jill Griffin Boulo, O.T.

  • Occupational Therapist
  • Mobile, AL
National Provider Identifier
1235197146
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1835 Issued in AL
Practice address
166 Mobile Infirmary Blvd
Mobile, AL 36607
Phone
(251) 435-2016
Fax
(251) 435-3069
NPI assigned
May 2, 2006
Last updated
Apr 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1835 AL Primary

Addresses

Primary practice location

166 Mobile Infirmary Blvd
Mobile, AL 36607

Mailing address

166 Mobile Infirmary Blvd
Mobile, AL 36607
Phone (251) 435-2016

Other identifiers 2

IdentifierTypeStateIssuer
051525906OtherALBCBS
890012810MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070814000822 AL Practitioner - Occupational Therapist in Private Practice 4385735760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Orthopaedic Group PCGroup PAC ID 2264331826, 67 clinicians

Practice addresses (Care Compare)

6144 Airport Blvd
Mobile, AL 36608-3143
Phone (251) 476-5050

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
86.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1835ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Group, P.C. CurrentSince Mar 21, 2010 Accepting new patients
The Orthopaedic Group, PC CurrentSince Mar 21, 2010 Accepting new patients
Coastal Anesthesia, P.C. Past Accepting new patients

Locations

6144 Airport Blvd
Mobile, AL 36608
Phone (251) 342-0004

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, 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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1235197146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MOBILE INFIRMARY BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36607",
            "telephone_number": "251-435-2016",
            "fax_number": "251-435-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MOBILE INFIRMARY BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36607",
            "telephone_number": "251-435-2016",
            "fax_number": "251-435-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULO",
        "first_name": "JILL",
        "middle_name": "GRIFFIN",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "1835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051525906",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890012810",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.