Active NPI
Jill Louise Sanborn, LMT
- Specialist
- Pinellas Park, FL
National Provider Identifier
1497051122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA0012859
- Practice address
- 4649 66TH PL N
Pinellas Park, FL 33781-5278 - Phone
- (727) 430-8752
- NPI assigned
- Jan 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA0012859 | FL | Primary |
Addresses
Primary practice location
4649 66TH PL N
Pinellas Park, FL 33781-5278
Mailing address
4649 66TH PL N
Pinellas Park, FL 33781-5278
Phone (727) 430-8752
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA0012859 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1497051122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4649 66TH PL N",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337815278",
"telephone_number": "727-430-8752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4649 66TH PL N",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337815278",
"telephone_number": "727-430-8752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANBORN",
"first_name": "JILL",
"middle_name": "LOUISE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-27",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA0012859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinellas Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.