Individual provider Active NPI

Jennifer Marie Quill, PT

  • Physical Therapist
  • Parma, OH
National Provider Identifier
1649296575
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009289 Issued in OH
Practice address
5520 Broadview Rd FRNT
Parma, OH 44134-1605
Phone
(216) 749-6650
Fax
(216) 749-1655
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 PT009289 OH Primary

Addresses

Primary practice location

5520 Broadview Rd FRNT
Parma, OH 44134-1605

Mailing address

5000 Rockside Rd Ste 500
Independence, OH 44131-2178
Phone (216) 459-2846

Other practice location 1

435 W Liberty St
Medina, OH 44256-2221
Phone (216) 749-6650

Other identifiers 2

IdentifierTypeStateIssuer
2419216MedicaidOH
11508482OtherOHCAQH

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
PT009289OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1649296575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 ROCKSIDE RD STE 500",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312178",
            "telephone_number": "216-459-2846",
            "fax_number": "216-901-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 BROADVIEW RD FRNT",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441341605",
            "telephone_number": "216-749-6650",
            "fax_number": "216-749-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 W Liberty St",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442562221",
            "country_code": "US",
            "telephone_number": "216-749-6650",
            "fax_number": "330-723-8920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUILL",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT009289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2419216",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11508482",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.