Tess Klossner, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

004602 Issued in NY

Practice address

11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438

Phone

(315) 774-8155

Fax

(315) 376-5061

NPI assigned

Jan 16, 2022

Last updated

Nov 22, 2023By 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

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1073264578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 N 5TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478091903",
            "telephone_number": "812-237-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-774-8155",
            "fax_number": "315-376-5061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478091903",
            "country_code": "US",
            "telephone_number": "812-237-9613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOSSNER",
        "first_name": "TESS",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-16",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "004602",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003538A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Kim, M.D.
• John David King
• Ian Kinkel, DPT
• Morgan Rae Kitto, LCSW
• Kyle Jay Klahs, DO
• Andrew Jerome Kosmowski, MD
• Benjamin Robert Kosteva, ATC
• Elizabeth Kramer
• Mark James Kriezis, MSW
• Stephen Gerald Kulka, DMD

• Athletic Trainer in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.