Jessica Marie Oudekerk, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CHIR009798 Issued in GA

Practice address

1792 Woodstock Rd Ste 450
Roswell, GA 30075-5615

Phone

(404) 480-3311

Fax

(770) 727-8136

NPI assigned

Jul 12, 2018

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanta Spine and Wellness - Roswell LLC

  • Chiropractor
  • Roswell, GA
  • NPI 1548151954
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1235615386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 WOODSTOCK RD STE 450",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755615",
            "telephone_number": "478-397-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 WOODSTOCK RD STE 450",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755615",
            "telephone_number": "404-480-3311",
            "fax_number": "770-727-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5070 Peachtree Blvd Ste E170",
            "address_purpose": "LOCATION",
            "city": "Chamblee",
            "state": "GA",
            "postal_code": "303413010",
            "country_code": "US",
            "telephone_number": "770-392-9299",
            "fax_number": "404-727-8136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUDEKERK",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009798",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osama Saad Hindash
• Dana Wordsworth Osborn, PNP
• Ot4Kids LLC (Sharon Mendoza)
• Allison Otting, MA CCC-SLP
• Jill Otto
• Leonard Packtor, DDS
• Barbara Orr Pagillo, PT
• Pain and Accident Chiropractic-Roswell LLC (Pain and Accident Chiropractic)
• Painlogics LLC
• Jennifer Ko Pak, PT

• Rehabilitation Chiropractor in Roswell, GA
• Providers in Roswell, GA by specialty
• Rehabilitation Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.