JILLIAN DANIELLE SHIEMBOB (PT) – Physical Therapist, NPI 1679868939
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
300 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VT
Provider Addresses for JILLIAN DANIELLE SHIEMBOB (PT)
5121 S COTTONWOOD ST
MURRAY, UT 841075701
Phone: (801) 507-7577
Type: Mailing
235 LAKEMONT RD
NEWPORT, VT 058559507
Phone: (802) 334-8558
Fax: (802) 334-8559
Type: Location
660 S 200 E
SALT LAKE CITY, UT 841113835
Phone: (801) 359-2256
Type: Mailing
3025 S PLATEAU DR
SALT LAKE CITY, UT 841092320
Phone: (413) 348-8247
Type: Mailing
6330 S 3000 E
COTTONWOOD HEIGHTS, UT 841216233
Phone: (413) 348-8247
Fax: (802) 334-8559
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-02-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180216000607 | I | Physical Therapist In Private Practice | UT | TBD |
| I20230202002388 | I | Physical Therapist In Private Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| Physical Therapist In Private Practice | UT | |
| Nurse Practitioner | UT | |
| Physician Assistant | UT | |
| Clinical Social Worker | UT | |
| Clinical Social Worker | UT | |
| Clinical Social Worker | UT | |
| Clinical Social Worker | UT | |
| Occupational Therapist In Private Practice | CO | |
| Clinical Social Worker | UT |
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