Active NPI
Jill M Eide, OTR/L
- Occupational Therapist
- West Allis, WI
National Provider Identifier
1558920389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 663
- Practice address
- 8901 W Lincoln Ave
West Allis, WI 53227-2409 - Phone
- (414) 328-6640
- NPI assigned
- Jun 5, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 663 | WI | Primary |
Addresses
Primary practice location
8901 W Lincoln Ave
West Allis, WI 53227-2409
Mailing address
3587 S 75TH St
Milwaukee, WI 53220-1137
Phone (414) 588-3587
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 |
|---|---|---|---|
| 663 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1558920389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3587 S 75TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532201137",
"telephone_number": "414-588-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 W LINCOLN AVE",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532272409",
"telephone_number": "414-328-6640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIDE",
"first_name": "JILL",
"middle_name": "M",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.