Individual provider Active NPI

Jill Elliott, MSPT

  • Physical Therapist
  • Lewes, DE
National Provider Identifier
1851403034
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0000965 Issued in DE
Practice address
20684 John J Williams Hwy Ste 2
Lewes, DE 19958-4393
Phone
(302) 945-0200
Fax
(302) 945-6959
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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 J1-0000965 DE Primary

Addresses

Primary practice location

20684 John J Williams Hwy Ste 2
Lewes, DE 19958-4393

Mailing address

106 Milford St Ste 601
Salisbury, MD 21804-6938
Phone (410) 548-7600

Other identifiers 1

IdentifierTypeStateIssuer
1851403034MedicaidDE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0000965DEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1851403034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST STE 601",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046938",
            "telephone_number": "410-548-7600",
            "fax_number": "410-548-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20684 JOHN J WILLIAMS HWY STE 2",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584393",
            "telephone_number": "302-945-0200",
            "fax_number": "302-945-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JILL",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0000965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851403034",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.