Individual provider Active NPI

Jillian Elizabeth Wiggill, MSOT, OTR

  • Occupational Therapist
  • Mooresville, NC
National Provider Identifier
1447912886
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
15954 Issued in NC
Practice address
134 Infield CT
Mooresville, NC 28117-8026
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 15954 NC Primary

Addresses

Primary practice location

134 Infield CT
Mooresville, NC 28117-8026

Mailing address

134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824

Other practice location 1

17507 Lee Hwy
Abingdon, VA 24210-7835
Phone (276) 525-6043

Other practice location 2

280 Charlois Blvd
Winston Salem, NC 27103-1588
Phone (704) 799-6824

Other names 1

  • Jillian Elizabeth Lemos Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618000703 NC Practitioner - Occupational Therapist in Private Practice 1052822806 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15954NCMDCritical Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidology, Inc Occupational Therapist CurrentSince May 19, 2025 Accepting new patients
Integrative Therapy Concepts PastSince Jul 23, 2023 Accepting new patients
Lolly Therapeutics, LLC Occupational Therapist PastSince Jul 23, 2023 Accepting new patients

Locations

1244 N Flint St
Lincolnton, NC 28092
Phone (704) 740-0676

901 W Main St
Yadkinville, NC 27055
Phone (336) 679-2931

Organizations & group practices 3

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1447912886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17507 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242107835",
            "country_code": "US",
            "telephone_number": "276-525-6043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Charlois Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031588",
            "country_code": "US",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGILL",
        "first_name": "JILLIAN",
        "middle_name": "ELIZABETH",
        "credential": "MSOT, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "15954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "LEMOS",
            "middle_name": "ELIZABETH",
            "credential": "MSOT, OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.