Active NPI
Jill Matthew, OTR/L
- Occupational Therapist
- Lexington Park, MD
National Provider Identifier
1942772504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 08146
- Practice address
- 46060 Millstone Landing Rd
Lexington Park, MD 20653-2149 - Phone
- (518) 859-4776
- NPI assigned
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 08146 | MD | Primary |
Addresses
Primary practice location
46060 Millstone Landing Rd
Lexington Park, MD 20653-2149
Mailing address
46580 Purcell Farm LN
Drayden, MD 20630-3205
Phone (518) 859-4776
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08146 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1942772504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46580 PURCELL FARM LN",
"city": "DRAYDEN",
"state": "MD",
"postal_code": "206303205",
"telephone_number": "518-859-4776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46060 MILLSTONE LANDING RD",
"city": "LEXINGTON PARK",
"state": "MD",
"postal_code": "206532149",
"telephone_number": "518-859-4776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEW",
"first_name": "JILL",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-20",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "08146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.