Individual provider Active NPI

Jennifer Lull, DPT

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1396155412
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2013023355 Issued in MO
Practice address
35 Hudson St
Apt 3408
Jersey City, NJ 07302-6606
Phone
(785) 550-9540
NPI assigned
Apr 28, 2014
Last updated
Feb 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-04615 KS
Physical Therapist 225100000X 2013023355 MO Primary

Addresses

Primary practice location

35 Hudson St
Apt 3408
Jersey City, NJ 07302-6606

Mailing address

35 Hudson St
Apt. 3408
Jersey City, NJ 07302-6606
Phone (785) 550-9540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160302001377 NY Practitioner - Physical Therapist in Private Practice 5698092591 Reassigns benefits to 1 organization
I20180720000111 PA Practitioner - Physical Therapist in Private Practice 5698092591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-04615KSMDPhysical Therapist
2013023355MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1396155412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HUDSON ST",
            "address_2": "APT. 3408",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026606",
            "telephone_number": "785-550-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HUDSON ST",
            "address_2": "APT 3408",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026606",
            "telephone_number": "785-550-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LULL",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-04615",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2013023355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.