Jill M. Edlin
Individual provider Active NPI Occupational Therapist · Lebanon, KY
NPI 1295941771 · NPPES record last updated Aug 9, 2016
Key facts
- NPI
- 1295941771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 134718 (KY)
- Practice address
- 315 Rosewood St
Lebanon, KY 40033-8128 - Phone
- (270) 699-2776
- Fax
- (270) 699-2780
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134718 | KY | MD | Occupational Therapist |
| KY-R3058 | KY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenwell & Greenwell, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | KY-R3058 | KY | |
| Occupational Therapist | 225X00000X | 134718 | KY | Yes |
Addresses
Primary practice location
315 Rosewood St
Lebanon, KY 40033-8128
Mailing address
315 Rosewood St
Lebanon, KY 40033-8128
Phone (270) 699-2776
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649 | Other | KY | FIRST STEPS PROVIDER |
| 2245 | Other | KY | FIRST STEPS PROVIDER |
Other providers in Lebanon, KY
- Kelly Renee Deatley
- Deanna Delaney
- Deborah L. Doyle
- William Price Duley III
- Michael Dean Eastridge
- Kimberly Katherine Edrington
- Stephen Ewing
- Family & Internal Medicine Associates PLLC
- Amelia R Farmer
- Fast Pace Kentucky, PLLC
All providers in Lebanon, KY · Occupational Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.