Steven I Jessup, M.A. LIC. ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-260 Issued in ID

Practice address

980 W Ironwood Dr
Suite 207
Coeur D Alene, ID 83814-2668

Phone

(208) 770-2971

Fax

(208) 770-2974

NPI assigned

Feb 6, 2008

Sex

Male

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1144408618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 IRONWOOD DR.",
            "address_2": "SUITE 207",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-770-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR",
            "address_2": "SUITE 207",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-770-2971",
            "fax_number": "208-770-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "STEVEN",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "M.A. LIC. ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.