Individual provider Active NPI

Jillian Kathleen Ross, A.P.R.N.

  • Family Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1427337666
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004688 Issued in CT
Practice address
55 Walls Dr., Suite 405
Fairfield, CT 06825-5163
Phone
(203) 259-7070
Fax
(203) 254-7402
NPI assigned
Aug 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 004688 CT Primary

Addresses

Primary practice location

55 Walls Dr., Suite 405
Fairfield, CT 06825-5163

Mailing address

1224 Mill St
Ste 224
East Berlin, CT 06023-1159
Phone (480) 862-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000483 CT Practitioner - Nurse Practitioner 4587836820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy and Asthma Care of Fairfield County LLCGroup PAC ID 4688579980, 4 clinicians

Practice addresses (Care Compare)

55 Walls Dr
Suite 405
Fairfield, CT 06824-5163
Phone (203) 259-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
004688CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy and Asthma Care of Fairfield County, LLC CurrentSince Mar 10, 2018 Accepting new patients
MVC CT PastSince Jul 24, 2022 Accepting new patients

Locations

55 Walls Dr
Ste 105
Fairfield, CT 06824

55 Walls Dr
Ste 405
Fairfield, CT 06824
Phone (203) 259-7070

55 Walls Dr
#405
Fairfield, CT 06824
Phone (203) 259-7070

35 Corporate Dr
Ste 1115
Trumbull, CT 06611
Phone (203) 259-7070

Interoperability endpoints

  • Direct secure messaging: jillian.ross@allergyasthmacareoffairfieldco.chartmakerdirect.com

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": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427337666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 MILL ST",
            "address_2": "STE 224",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231159",
            "telephone_number": "480-862-1700",
            "fax_number": "480-718-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WALLS DR., SUITE 405",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068255163",
            "telephone_number": "203-259-7070",
            "fax_number": "203-254-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JILLIAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.