Individual provider Active NPI

Jayne E. Ninness, LPTA

  • Physical Therapy Assistant
  • Belleville, IL
National Provider Identifier
1396168332
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.003204 Issued in IL
Practice address
4500 Memorial Dr.
Memorial Hospital
Belleville, IL 62226
Phone
(618) 233-7750
Fax
(618) 257-6911
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.003204 IL Primary

Addresses

Primary practice location

4500 Memorial Dr.
Memorial Hospital
Belleville, IL 62226

Mailing address

3801 Old Bruceville Road
Trurehab
Vincennes, IN 47591
Phone (812) 886-4670

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
160.003204ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1396168332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 OLD BRUCEVILLE ROAD",
            "address_2": "TRUREHAB",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "47591",
            "telephone_number": "812-886-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR.",
            "address_2": "MEMORIAL HOSPITAL",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-233-7750",
            "fax_number": "618-257-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINNESS",
        "first_name": "JAYNE",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.003204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.