Individual provider Active NPI

Jennifer Till

  • Physical Therapist
  • Crestview Hills, KY
National Provider Identifier
1447609078
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.007042 Issued in KY
Practice address
544 Centre View Blvd.
Crestview Hills, KY 41017-3400
Phone
(513) 221-1100
Fax
(513) 569-5225
NPI assigned
Jun 4, 2016
Last updated
May 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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 PT.014175 OH
Physical Therapist 225100000X PT.007042 KY Primary

Addresses

Primary practice location

544 Centre View Blvd.
Crestview Hills, KY 41017-3400

Mailing address

PO Box 643398
Cincinnati, OH 45264-3398
Phone (513) 221-1100

Other practice location 1

3825 Edwards Rd Ste 300
Cincinnati, OH 45209-1288
Phone (513) 221-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171208001662 OH Practitioner - Physical Therapist in Private Practice 2062779531 Reassigns benefits to 1 organization
I20200602002437 KY Practitioner - Physical Therapist in Private Practice 2062779531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayfield Clinic IncGroup PAC ID 9133013006, 74 clinicians

Practice addresses (Care Compare)

3825 Edwards Rd
Suite 300
Cincinnati, OH 45209-1288
Phone (513) 221-1100

544 Centre View Blvd
Crestview Hills, KY 41017-3400
Phone (513) 221-1100

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.007042KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfield Clinic Inc Physical Therapist CurrentSince Nov 13, 2017 Accepting new patients
Mayfield Clinic Inc CurrentSince Nov 13, 2017 Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

544 Centre View Blvd
Crestview Hills, KY 41017

3825 Edwards Rd
Ste 300
Cincinnati, OH 45209

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: jennifer.till@mayfield.eclinicaldirectplus.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, 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": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1447609078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643398",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452643398",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 CENTRE VIEW BLVD.",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173400",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Edwards Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452091288",
            "country_code": "US",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILL",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-04",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.014175",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT.007042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.