Active NPI
Jill Wittke Ryan, OTR/L
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1831283258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4829
- Practice address
- 2320 Dahlgreen Rd
Raleigh, NC 27615 - Phone
- (919) 847-2674
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4829 | NC | Primary |
Addresses
Primary practice location
2320 Dahlgreen Rd
Raleigh, NC 27615
Mailing address
2320 Dahlgreen Rd
Raleigh, NC 27615
Phone (919) 847-2674
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4829 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254873600000",
"number": "1831283258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2320 DAHLGREEN RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27615",
"telephone_number": "919-847-2674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2320 DAHLGREEN RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27615",
"telephone_number": "919-847-2674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "JILL",
"middle_name": "WITTKE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2009-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "4829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.