Individual provider Active NPI

Jillian A Douglas

  • Occupational Therapy Assistant
  • Belton, TX
National Provider Identifier
1881069193
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
212333 Issued in TX
Practice address
10 E Shawnee LN
Belton, TX 76513-6631
Phone
(254) 913-9009
NPI assigned
Dec 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212333 TX Primary

Addresses

Primary practice location

10 E Shawnee LN
Belton, TX 76513-6631

Mailing address

10 E Shawnee LN
Belton, TX 76513-6631
Phone (254) 913-9009

Other practice location 1

5249 Fm 1181
Ennis, TX 75119-5524
Phone (254) 913-9009

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
212333TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1881069193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E SHAWNEE LN",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765136631",
            "telephone_number": "254-913-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E SHAWNEE LN",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765136631",
            "telephone_number": "254-913-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5249 Fm 1181",
            "address_purpose": "LOCATION",
            "city": "Ennis",
            "state": "TX",
            "postal_code": "751195524",
            "country_code": "US",
            "telephone_number": "254-913-9009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JILLIAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.