Jillian Therese Witwicki

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5048 Issued in NH

Practice address

23 Crystal Ave Unit 2a
Derry, NH 03038-2425

Phone

(603) 437-3338

NPI assigned

Aug 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of New England, College of Osteo Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derry Sports and Rehab LLCGroup PAC ID 1052666807, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Derry Sports & Rehab, LLC

  • Physical Therapist
  • Derry, NH
  • NPI 1487670386
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1780302273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HOLTEN ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232669",
            "telephone_number": "978-854-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CRYSTAL AVE UNIT 2A",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382425",
            "telephone_number": "603-437-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITWICKI",
        "first_name": "JILLIAN",
        "middle_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "5048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Winn, BCBA
• Caroline Winn
• Carrie E Winn, MA
• Winnipesaukee ABA Services, LLC
• Chelsey Winslow, APRN
• Kelley Wood
• Sarah L Wood, OD
• Susan Wood
• Paul H Wright, LPSYCH NH#666
• Kimberly Wyatt

• Physical Therapist in Derry, NH
• Providers in Derry, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.