Individual provider Active NPI

Jillian Herbert, OTR/L

  • Occupational Therapist
  • Garland, TX
National Provider Identifier
1396103149
Registry record updated Dec 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
116621 Issued in TX
Practice address
930 W Centerville Rd
Suite 930C
Garland, TX 75041-5823
Phone
(972) 303-7021
Fax
(972) 303-7020
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 116621 TX Primary

Addresses

Primary practice location

930 W Centerville Rd
Suite 930C
Garland, TX 75041-5823

Mailing address

305 NE Loop 820
Business Tower 1, Suite 200
Hurst, TX 76053-7209
Phone (817) 292-8787

Other names 1

  • Jillian Wahl Former name

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

LicenseStateTypeSpecialty
116621TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Pediatric Therapy, LP. Past Accepting new patients
Epic Pediatric Therapy, LP Past 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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545436800000",
    "number": "1396103149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE LOOP 820",
            "address_2": "BUSINESS TOWER 1, SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760537209",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W CENTERVILLE RD",
            "address_2": "SUITE 930C",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415823",
            "telephone_number": "972-303-7021",
            "fax_number": "972-303-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "JILLIAN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2018-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "WAHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2018; 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.