Individual provider Active NPI

Jessica Kledzinski, ATC

  • Athletic Trainer
  • Colorado Springs, CO
National Provider Identifier
1306360342
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
Q797150101623 Issued in MN
Practice address
5516 Big Paw Heights
Colorado Springs, CO 80919
Phone
(763) 370-9553
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Q797150101623 MN Primary

Addresses

Primary practice location

5516 Big Paw Heights
Colorado Springs, CO 80919

Mailing address

5516 Big Paw HTS
Colorado Springs, CO 80919-3773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
Q797150101623MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1306360342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 BIG PAW HTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 BIG PAW HEIGHTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80919",
            "telephone_number": "763-370-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEDZINSKI",
        "first_name": "JESSICA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "Q797150101623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.