Individual provider Active NPI

Jillian Ingrid Ball, OTR/L

  • Occupational Therapist
  • Shelton, CT
National Provider Identifier
1568089001
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5381 Issued in CT
Practice address
100 Beard Sawmill Rd Ste 282
Shelton, CT 06484-6175
Phone
(475) 239-5512
NPI assigned
Jul 1, 2020
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5381 CT Primary

Addresses

Primary practice location

100 Beard Sawmill Rd Ste 282
Shelton, CT 06484-6175

Mailing address

320 Wildwood Dr
Orange, CT 06477-1623
Phone (203) 500-8857

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
5381CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Pathology Group LLC Occupational Therapist CurrentSince Jul 27, 2020 Accepting new patients
Speech Pathology Group LLC Occupational Therapist CurrentSince Aug 1, 2020 Accepting new patients

Locations

100 Beard Sawmill Rd
Ste 282
Shelton, CT 06484
Phone (475) 239-5512

Organizations & group practices 2

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": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1568089001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WILDWOOD DR",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771623",
            "telephone_number": "203-500-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BEARD SAWMILL RD STE 282",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846175",
            "telephone_number": "475-239-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "JILLIAN",
        "middle_name": "INGRID",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.