Individual provider Active NPI

Jill Ann Glover, P.T.

  • Physical Therapist
  • Elkhorn, NE
National Provider Identifier
1558401166
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
694 Issued in NE
Practice address
22117 Stanford Cir
Elkhorn, NE 68022-2272
Phone
(402) 250-3789
NPI assigned
Feb 6, 2007
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Physical Therapist 225100000X 694 NE Primary

Addresses

Primary practice location

22117 Stanford Cir
Elkhorn, NE 68022-2272

Mailing address

22117 Stanford Cir
Elkhorn, NE 68022-2272
Phone (402) 250-3789

Other practice location 1

16003 Josephine St
Omaha, NE 68136-1052
Phone (402) 650-2070

Other identifiers 2

IdentifierTypeStateIssuer
1MedicaidNE
47070762200MedicaidNE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
694NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maxability Therapy Services, P.C. Physical Therapist CurrentSince May 13, 2019 Accepting new patients

Locations

1001 Fort Crook Rd N
Ste 202
Bellevue, NE 68005
Phone (402) 391-5002

10909 Mill Valley Rd
Ste 210
Omaha, NE 68154
Phone (402) 391-5002

Organizations & group practices 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1558401166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22117 STANFORD CIR",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222272",
            "telephone_number": "402-250-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22117 STANFORD CIR",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222272",
            "telephone_number": "402-250-3789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16003 Josephine St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681361052",
            "country_code": "US",
            "telephone_number": "402-650-2070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JILL",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070762200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.