Individual provider Active NPI

Jill T Lewis, MSPT

  • Physical Therapist
  • Tappahannock, VA
National Provider Identifier
1396166732
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
900 South Church Lane
Tappahannock, VA 22560
Phone
(804) 443-4851
NPI assigned
Jan 3, 2014
Last updated
Jul 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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 Primary

Addresses

Primary practice location

900 South Church Lane
Tappahannock, VA 22560

Mailing address

PO Box 1401
Tappahannock, VA 22560-1401
Phone (804) 443-4850

Other identifiers 2

IdentifierTypeStateIssuer
2305006664OtherVAVIRGINIA STATE MEDICAL LICENSE
1396166732MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000421 VA Practitioner - Physical Therapist in Private Practice 8729099767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essex Physical Therapy, Inc.Group PAC ID 2567484595, 3 clinicians

Practice addresses (Care Compare)

PO Box
Suite 1401
Tappahannock, VA 22560

PO Box
Suite 1401
Tappahannock, VA 22560-1401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Essex Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2014 Accepting new patients

Locations

900 Church Ln
Tappahannock, VA 22560
Phone (804) 443-4850

Organizations & group practices 1

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": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1396166732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1401",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225601401",
            "telephone_number": "804-443-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SOUTH CHURCH LANE",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "22560",
            "telephone_number": "804-443-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JILL",
        "middle_name": "T",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE MEDICAL LICENSE",
            "identifier": "2305006664",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396166732",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tappahannock, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.