Individual provider Active NPI

Jill L Vancil

  • Developmental Therapist
  • Jacksonville, FL
National Provider Identifier
1497097349
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
9000 Southside Blvd BLDG 900
Jacksonville, FL 32256-0791
Phone
(904) 732-4343
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

9000 Southside Blvd BLDG 900
Jacksonville, FL 32256-0791

Mailing address

349 Carolina Jasmine LN
St Johns, FL 32259-4037
Phone (850) 225-2917

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Autism Clinic LLC CurrentSince May 16, 2021 Accepting new patients
Jacksonville School for Autism CurrentSince Sep 1, 2019 Accepting new patients
Jsa Clinical Group, Inc. Developmental Therapist PastSince Aug 25, 2019 Accepting new patients

Locations

9000 Cypress Green Dr
Jacksonville, FL 32256
Phone (904) 732-4343

9000 Southside Blvd
Unit 900
Jacksonville, FL 32256
Phone (904) 732-4343

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1497097349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 CAROLINA JASMINE LN",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322594037",
            "telephone_number": "850-225-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SOUTHSIDE BLVD BLDG 900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560791",
            "telephone_number": "904-732-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCIL",
        "first_name": "JILL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.