Jenna Gosselin, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096005404 Issued in IL

Practice address

3225 W Foster Ave
Chicago, IL 60625-4823

Phone

(603) 657-5329

NPI assigned

Sep 21, 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

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": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1114640539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 N CLARENDON AVE APT 807",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135202",
            "telephone_number": "603-657-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606254823",
            "telephone_number": "603-657-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "JENNA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096005404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason M. Gosnell, M.D.
• Ann Elizabeth Goss, LSW
• Mandy Goss
• Noah Ryan Goss, PA-C
• Holly Gosse, M.S., LCPC
• Dana R Gossett, MD
• Ryan William Gossett, M.ED., NCC, LPC
• Shardai Gossett, DNP, CNM
• Akya Charmel Gossitt, LSW
• Shytaura A Goston, R.O.T,

• Athletic Trainer in Chicago, IL
• Providers in Chicago, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.