Individual provider Active NPI

Jennifer Wells Roller, MPT

  • Physical Therapist
  • Springfield, OH
National Provider Identifier
1306054358
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011645 Issued in OH
Practice address
2221 Grube St
Springfield, OH 45503-2642
Phone
(937) 399-8941
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011645 OH Primary

Addresses

Primary practice location

2221 Grube St
Springfield, OH 45503-2642

Mailing address

301 S Mechanic St
Lebanon, OH 45036-2213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200507003253 OH Practitioner - Physical Therapist in Private Practice 2264863224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outpatient at Home LLCGroup PAC ID 6204248784, 38 clinicians

Practice addresses (Care Compare)

965 High St
Worthington, OH 43085-4065
Phone (614) 784-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011645OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Physical Therapy, LLC Physical Therapist PastSince Nov 20, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1306054358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S MECHANIC ST",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450362213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 GRUBE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032642",
            "telephone_number": "937-399-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "JENNIFER",
        "middle_name": "WELLS",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "011645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.