Active NPI
Molly R Gill, PT
- Physical Therapist
- Bloomington, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070025416
- Practice address
- 2103 N Veterans Pkwy Ste 332
Bloomington, IL 61704-0917 - Phone
- (309) 585-1809
- NPI assigned
- Mar 13, 2018
- Last updated
- Aug 26, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070025416 | IL | Primary |
Addresses
Primary practice location
2103 N Veterans Pkwy Ste 332
Bloomington, IL 61704-0917
Mailing address
1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200
Other practice location 1
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700
Other practice location 2
720 S VanBuren St
Green Bay, WI 54301-3504
Phone (920) 433-3420
Other practice location 3
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7822
Other practice location 4
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070025416 | Other | IL | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Bank Ave
Suite C
Kaukauna, WI 54130-2582
Phone (920) 759-9075
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070025416 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Physical Therapist | Current | Accepting new patients |
| Bellin Memorial Hospital, Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Orthopedic and Spine Therapy of Menasha SC | Physical Therapist | Current | Accepting new patients |
| Orthopedic & Spine Therapy of Menasha SC | Physical Therapist | Current | Accepting new patients |
| Orthopedic & Spine Therapy of Menasha SC | Physical Therapist | Past | Accepting new patients |
| Bellin Psychiatric Center Inc. | Past | Accepting new patients |
Locations
4000 N Providence Ave
Appleton, WI 54913
Phone (920) 257-2000
1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700
2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817
3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1 Bank Ave
Ste C
Kaukauna, WI 54130
Phone (920) 759-9075
1000 Midway Rd
Menasha, WI 54952
Phone (920) 257-2000
Organizations & group practices 8
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.
-
- Physical Therapist
- Kaukauna, WI
- NPI 1831260611
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
- Physical Therapy Clinic/Center
- New London, WI
- NPI 1437187135
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
Physical Therapist
-
- Rehabilitation Hospital Unit
- Green Bay, WI
- NPI 1174689178
-
- Physical Therapist
- Appleton, WI
- NPI 1932136322
-
dba Bellin Behavioral Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Green Bay, WI
- NPI 1598728776
-
- Physical Therapist
- Menasha, WI
- NPI 1205863602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1831692219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1377 MOTOR PKWY STE 307",
"city": "ISLANDIA",
"state": "NY",
"postal_code": "117495258",
"telephone_number": "631-580-5200",
"fax_number": "631-824-9335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2103 N VETERANS PKWY STE 332",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617040917",
"telephone_number": "309-585-1809"
}
],
"practiceLocations": [
{
"address_1": "3263 Eaton Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116830",
"country_code": "US",
"telephone_number": "920-433-6700",
"fax_number": "920-433-6719",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "720 S VanBuren St",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013504",
"country_code": "US",
"telephone_number": "920-433-3420",
"fax_number": "920-433-3788",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-7822",
"fax_number": "920-433-3651",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1630 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543135753",
"country_code": "US",
"telephone_number": "920-430-4750",
"fax_number": "920-430-4746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GILL",
"first_name": "MOLLY",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-13",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070025416",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "070025416",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.