Individual provider Active NPI

Jill Amy Scibelli, MSN, MBA, RN

  • Ambulatory Care Registered Nurse
  • West Springfield, MA
National Provider Identifier
1558958108
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
RN266393 Issued in MA
Practice address
928 Riverdale St
West Springfield, MA 01089-4620
Phone
(413) 733-6430
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X RN266393 MA Primary

Addresses

Primary practice location

928 Riverdale St
West Springfield, MA 01089-4620

Mailing address

21 Pleasant St
East Longmeadow, MA 01028-2440
Phone (413) 335-9184

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CVS

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
Credentials
Master of Business Administration, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN266393MAMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1558958108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PLEASANT ST",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282440",
            "telephone_number": "413-335-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 RIVERDALE ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010894620",
            "telephone_number": "413-733-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIBELLI",
        "first_name": "JILL",
        "middle_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "MSN, MBA, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MA",
            "license": "RN266393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "address_1": "928 Riverdale St",
            "city": "West Springfield",
            "state": "MA",
            "country_code": "US",
            "postal_code": "010894620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.