Individual provider Active NPI

Anna Marie Jilla, AUD, PHD

  • Audiologist
  • Beaumont, TX
National Provider Identifier
1285149039
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81314 Issued in TX
Practice address
4942 Rolfe Christopher Drive
Beaumont, TX 77705
Phone
(409) 880-8171
Fax
(409) 880-2265
NPI assigned
Dec 1, 2017
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4726 OK
Audiologist 231H00000X 1186A AL
Audiologist 231H00000X 9751 LA
Audiologist 231H00000X 81314 TX Primary

Addresses

Primary practice location

4942 Rolfe Christopher Drive
Beaumont, TX 77705

Mailing address

PO Box 10076
Beaumont, TX 77710-0076
Phone (409) 880-8171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221001651 TX Practitioner - Qualified Audiologist 4688086499 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1186AALMDAudiologist
9751LAMDAudiologist
4726OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lamar University Audiologist CurrentSince Nov 22, 2024 Accepting new patients

Locations

211 Redbird Ln
Beaumont, TX 77705
Phone (409) 880-2359

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": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1285149039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10076",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777100076",
            "telephone_number": "409-880-8171",
            "fax_number": "409-880-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4942 ROLFE CHRISTOPHER DRIVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77705",
            "telephone_number": "409-880-8171",
            "fax_number": "409-880-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JILLA",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AUD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "4726",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "1186A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "LA",
            "license": "9751",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.