Jill Suzanne Daniels, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2429 Issued in WV

Practice address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Phone

(304) 766-3589

Fax

(304) 766-3793

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mountaineer Physical Therapy & Sports Medicine

  • Physical Therapist
  • Summersville, WV
  • NPI 1528047529
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1508845595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3589",
            "fax_number": "304-766-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3589",
            "fax_number": "304-766-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "2429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000883",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damous Psychological Services PLLC
• Damous Psychological Services PLLC
• George Michael Damous, M.A., ED.S.
• Cathy Damron
• Dymonte Daniels
• Linda Daniels
• Tonia M Daniels, C-FNP
• Virginia Danz, MA
• Llayton Darnall
• Julie Darnell

• Physical Therapist in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.