Jenna Lynne Dehoet, ATC/LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.003427 Issued in IL

Practice address

1103 40TH St
Rock Island, IL 61201-3114

Phone

(309) 786-7793

NPI assigned

Apr 18, 2013

Last updated

Apr 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166
  NPD (past)
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490
  NPD (past)

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1013351311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 300",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 40TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612013114",
            "telephone_number": "309-786-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHOET",
        "first_name": "JENNA",
        "middle_name": "LYNNE",
        "credential": "ATC/LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003427",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "000937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Debrackeleire, M.A.
• Kaitlynn Mae Decker
• Haley Deering
• Andrew Clark Defrees
• Jeremy Thomas Degroff
• Cassandra Delgado, MSW
• Katelyn Mae Dempkowski
• Alyx Milani Dereu, LCPC
• Jesse Desilva
• Amelia Victoria Devera Sales, FNP-C

• Athletic Trainer in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.