Jill Self, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2503 Issued in AR

Practice address

806 Glendale St
Jonesboro, AR 72401-4455

Phone

(870) 933-9528

NPI assigned

Jun 6, 2011

Last updated

Jun 6, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1346534427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 COUNTY ROAD 620",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 GLENDALE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014455",
            "telephone_number": "870-933-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "JILL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2503",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerin J Seevers
• Sydnee Segars
• Brianna Leigh Segraves
• Kim Rana Segraves, LCSW
• Karrah Seitz, LPC
• Margaret Meagan Self, APRN
• Cristina Sellers, PHARMD
• Mary E Sellers, QBHP
• Tiara Selmon
• Sensational Kids

• Physical Therapy Assistant in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.