Individual provider Active NPI

Jill Kilkenny, PT

  • Physical Therapist
  • Cedar Rapids, IA
National Provider Identifier
1588758486
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03148 Issued in IA
Practice address
227 Northland CT NE
Cedar Rapids, IA 52402-6226
Phone
(319) 377-0937
Fax
(319) 377-0948
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 03148 IA Primary

Addresses

Primary practice location

227 Northland CT NE
Cedar Rapids, IA 52402-6226

Mailing address

227 Northland CT NE
Cedar Rapids, IA 52402-6226
Phone (319) 377-0937

Other identifiers 2

IdentifierTypeStateIssuer
0665430MedicaidIA
2204667MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000858 IA Practitioner - Physical Therapist in Private Practice 3173563772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sandra H Sublett, PT, LLCGroup PAC ID 7012265077, 7 clinicians

Practice addresses (Care Compare)

227 Northland CT NE
Cedar Rapids, IA 52402-6226
Phone (319) 377-0937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03148IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra H Sublett, PT, LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Premier Health Associates, Inc. Past Accepting new patients

Locations

227 Northland Ct NE
Cedar Rapids, IA 52402
Phone (319) 270-8492

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1588758486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 NORTHLAND CT NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524026226",
            "telephone_number": "319-377-0937",
            "fax_number": "319-377-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 NORTHLAND CT NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524026226",
            "telephone_number": "319-377-0937",
            "fax_number": "319-377-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILKENNY",
        "first_name": "JILL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665430",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2204667",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.