Active NPI
Jill Marie Basil, M.O.T.
- Occupational Therapist
- Munster, IN
National Provider Identifier
1932231420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003833A
- Practice address
- 9050 Columbia Ave
Munster, IN 46321-2905 - Phone
- (219) 836-0193
- Fax
- (219) 836-0570
- NPI assigned
- Mar 10, 2007
- Last updated
- Jul 8, 2007
- 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 | 31003833A | IN | Primary |
Addresses
Primary practice location
9050 Columbia Ave
Munster, IN 46321-2905
Mailing address
9034 Columbia Ave
Munster, IN 46321-2905
Phone (219) 836-0296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000484843 | Other | IN | ANTHEM |
Other names 1
- Jill Marie Reidelbach
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31003833A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Network Inc | Past | Accepting new patients | |
| Max Health Clinic Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Powers Health Medical Group
- Family Medicine Physician
- Saint John, IN
- NPI 1457610487
-
- Physical Therapist
- Schererville, IN
- NPI 1467424689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932231420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9034 COLUMBIA AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212905",
"telephone_number": "219-836-0296",
"fax_number": "219-836-0570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9050 COLUMBIA AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212905",
"telephone_number": "219-836-0193",
"fax_number": "219-836-0570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASIL",
"first_name": "JILL",
"middle_name": "MARIE",
"credential": "M.O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003833A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000484843",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "REIDELBACH",
"middle_name": "MARIE",
"credential": "M.O.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.