Active NPI
Jillian Marzel Walsh
- Feeding, Eating & Swallowing Occupational Therapy Assistant
- Saint John, IN
National Provider Identifier
1336884998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Feeding, Eating & Swallowing Occupational Therapy Assistant
- License
- 32002180A
- Practice address
- 10700 Park PL
Saint John, IN 46373-8666 - Phone
- (219) 247-6459
- NPI assigned
- Apr 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Feeding, Eating & Swallowing Occupational Therapy Assistant | 224ZF0002X | 32002180A | IN | Primary |
Addresses
Primary practice location
10700 Park PL
Saint John, IN 46373-8666
Mailing address
9869 Garden Way
Saint John, IN 46373-0199
Phone (708) 828-2762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32002180A | IN | MD | Feeding, Eating & Swallowing Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1336884998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9869 GARDEN WAY",
"city": "SAINT JOHN",
"state": "IN",
"postal_code": "463730199",
"telephone_number": "708-828-2762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10700 PARK PL",
"city": "SAINT JOHN",
"state": "IN",
"postal_code": "463738666",
"telephone_number": "219-247-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "JILLIAN",
"middle_name": "MARZEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-28",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "224ZF0002X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
"state": "IN",
"license": "32002180A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint John, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.