Individual provider Active NPI

Jacqueline Denise McGill

  • Physical Therapy Assistant
  • Vincennes, IN
National Provider Identifier
1851542716
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06003772A Issued in IN
Practice address
3801 Old Bruceville Rd
Vincennes, IN 47591-3889
Phone
(181) 288-6467
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06003772A IN Primary

Addresses

Primary practice location

3801 Old Bruceville Rd
Vincennes, IN 47591-3889

Mailing address

5259 Carolina St
Gary, IN 46410-1542
Phone (219) 887-0649

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

LicenseStateTypeSpecialty
06003772AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1851542716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5259 CAROLINA ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464101542",
            "telephone_number": "219-887-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 OLD BRUCEVILLE RD",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475913889",
            "telephone_number": "181-288-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003772A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.