Jessica Lynn McClintock, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2011021957 Issued in MO

Practice address

3652 Stardust Dr
Hannibal, MO 63401-6212

Phone

(573) 221-8800

Fax

(573) 221-1808

NPI assigned

Jul 19, 2011

Last updated

Jul 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Lynn Bolte Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Macon Rehabilitation Services LLCGroup PAC ID 1456500537, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Macon Rehabilitation Services, LLC

  • Physical Therapy Clinic/Center
  • Macon, MO
  • NPI 1306197918
  Medicare reassignment Care Compare group
• Advance Hannibal Regional Hospital LLC

  • Physical Therapist
  • Palmyra, MO
  • NPI 1104684703
  NPD (past)
• Advance Physical Therapy & Sports Medicine of Lewis County LLC

  • Physical Therapist
  • Canton, MO
  • NPI 1326058322
  NPD (past)
• Advance PT Therapy of Hannibal LLC

  dba Advance Physical Therapy & Sports Medicine of Hannibal, LLC

  • Physical Therapist
  • Hannibal, MO
  • NPI 1588678403
  NPD (past)
• Boone Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1760893259
  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1023306586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016212",
            "telephone_number": "573-221-8800",
            "fax_number": "573-221-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016212",
            "telephone_number": "573-221-8800",
            "fax_number": "573-221-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2011021957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOLTE",
            "middle_name": "LYNN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie McAfee
• Mandy J. McAllister, FNP-C
• Olivia McBride
• Joshua Michael McCaskey, PLPC
• Kimberly McClelland, RN, MSN, RNFA
• Leslie A McCoy, D.O.
• Beth McDowell
• Suzanne Mardell McDowell, MSN, RN, PMHNP
• Bryson Roy McHardy Jr., M.D,.
• Haleigh M McKenzie, RDH

• Physical Therapist in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.