Individual provider Active NPI

Jill Christin Rose, PT

  • Physical Therapist
  • Lakewood Ranch, FL
National Provider Identifier
1649490095
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22420 Issued in FL
Practice address
11505 Palmbrush TRL
Lakewood Ranch, FL 34202-2917
Phone
(941) 747-2090
Fax
(941) 487-6233
NPI assigned
Apr 26, 2007
Last updated
Jun 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22420 FL Primary
Physical Therapist 225100000X 21535 MD
Physical Therapist 225100000X 5529209 NY

Addresses

Primary practice location

11505 Palmbrush TRL
Lakewood Ranch, FL 34202-2917

Mailing address

5285 Palm Isles Blvd
Sarasota, FL 34233-3955
Phone (773) 726-2401

Other identifiers 1

IdentifierTypeStateIssuer
Y0A2GOtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000612 FL Practitioner - Physical Therapist in Private Practice 4183797004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

6114 State Rd 70
Kaizen Total Wellness
Bradenton, FL 34203-9712
Phone (941) 315-6182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22420FLMDPhysical Therapist
21535MDMDPhysical Therapist
5529209NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists, LLC CurrentSince Jul 1, 2013 Accepting new patients
Florida Medical Specialists LLC Current Accepting new patients
Florida Medical Specialists LLC CurrentSince Jul 1, 2013 Accepting new patients
Florida Medical Specialists LLC Past Accepting new patients
Back in Motion Sarasota Physical Physical Therapist PastSince Jul 5, 2006 Accepting new patients
Neuromuscular Therapy Center Inc Physical Therapist Past Accepting new patients
Florida Medical Specialists, LLC Physical Therapist Past Accepting new patients
Best Value Healthcare LLC Past Accepting new patients
Universal Health Institute, LTD PastSince Dec 9, 2024 Accepting new patients

Locations

6114 State Road 70 E
Bradenton, FL 34203
Phone (941) 315-6182

7431 Manatee Ave W
Bradenton, FL 34209
Phone (941) 313-7142

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

3844 Bee Ridge Rd
Sarasota, FL 34233
Phone (941) 202-5342

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1649490095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 PALM ISLES BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333955",
            "telephone_number": "773-726-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 PALMBRUSH TRL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022917",
            "telephone_number": "941-747-2090",
            "fax_number": "941-487-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JILL",
        "middle_name": "CHRISTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22420",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21535",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "5529209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0A2G",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.