Jillian Eileen Gibbons Rose, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC010061 Issued in PA

Practice address

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Phone

(215) 879-1000

Fax

(215) 879-3912

NPI assigned

Jun 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jillian Eileen Gibbons Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972709962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 WOODRIDGE DR",
            "city": "GREEN LANE",
            "state": "PA",
            "postal_code": "180542285",
            "telephone_number": "215-219-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS ROSE",
        "first_name": "JILLIAN",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC010061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020254040001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "GIBBONS",
            "middle_name": "EILEEN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bruce J Giantonio, MD
• Rose M. Giardine, M.S.
• Alberto Andrea Giardini, DO
• Stephen Giardino
• Christina Suzanne Giatropoulos, M.S.
• Margaret A Gibbons-Lashendock, CRNP
• Allison Victoria Gibbons, DO
• Christina Marie-Noel Gibbons, MD
• Dorothy B Gibbons, LCSW
• Jessica Gibbons, DO

• Occupational Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.