Jessica Nicole Bledsoe, PTA

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

2012003666 Issued in MO

Practice address

3302 N Woodbine Rd
Saint Joseph, MO 64505-9323

Phone

(816) 820-8968

NPI assigned

Feb 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jessica Nicole Howe Former name

Electronic endpoints 3

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": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1184258188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 NE 43RD TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641162160",
            "telephone_number": "816-820-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 N WOODBINE RD",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645059323",
            "telephone_number": "816-820-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MO",
            "license": "2012003666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jessicabledsoe@specializedhc.com",
            "affiliation": "N",
            "address_1": "606 NE 43rd Ter",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641162160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jessicabledsoe@specializedhc.com",
            "affiliation": "N",
            "address_1": "3302 N Woodbine Rd",
            "city": "Saint Joseph",
            "state": "MO",
            "country_code": "US",
            "postal_code": "645059323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jessicabledsoe@specializedhc.com",
            "affiliation": "N",
            "address_1": "606 NE 43rd Ter",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641162160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HOWE",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ethan Blair, MA, PLPC
• David A Blaker, CRNA
• Terra Brean Blanchard, CPM
• Kevin Bland
• Amber Evelyn Blattner, M.A., CCC-SLP
• Bliss Manor, Inc.
• Bliss Manor, Inc.
• Bliss Manor, Inc.
• BLKC, Inc. (D/B/a Premier Compounding Pharmacy)
• Blue Hat LLC

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.