Jessenia Collazo, RN

Primary specialty

Rehabilitation Registered NurseTaxonomy code 163WR0400X

License

28268531A Issued in IN

Practice address

2901 W 37TH Ave
Hobart, IN 46342-1727

Phone

(219) 942-2179

Fax

(219) 942-7781

NPI assigned

Dec 23, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1083326862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5071 LAKEVIEW AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684195",
            "telephone_number": "219-743-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W 37TH AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463421727",
            "telephone_number": "219-942-2179",
            "fax_number": "219-942-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "JESSENIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "IN",
            "license": "28268531A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "don@watersofhobart.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 W 37th Ave",
            "city": "Hobart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463421727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bantu Samridhi Chhangani, MD
• Shelby Qian Chien, M.D., PHD
• City of Hobart
• Porscha Clair
• Mya Clark
• Comforting Hands Home Care Services LLC
• Community Anesthesia & Pain Treatment, LLC
• Community HC, LLC
• Connery Pediatrics, LLC
• Brett Cormier, MSW

• Rehabilitation Registered Nurse in Hobart, IN
• Providers in Hobart, IN by specialty
• Rehabilitation Registered Nurse in Indiana

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