Individual provider Active NPI

Jill M Deen, PT

  • Physical Therapist
  • Columbia, TN
National Provider Identifier
1659416477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000005771 Issued in TN
Practice address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone
(931) 381-1111
Fax
(931) 380-4108
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT0000005771 TN Primary

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401-4802

Mailing address

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

Other identifiers 1

IdentifierTypeStateIssuer
PT0000005771OtherTNPT LICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659416477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-381-1111",
            "fax_number": "931-380-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-381-1111",
            "fax_number": "931-380-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEN",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000005771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT0000005771",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.