Individual provider Active NPI

Jodelle Tessman

  • Physical Therapist
  • Roseville, MN
National Provider Identifier
1306552443
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6249 Issued in MN
Practice address
2945 Lincoln Dr
Roseville, MN 55113-1338
Phone
(651) 628-3000
NPI assigned
Jan 23, 2023
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6249 MN Primary

Addresses

Primary practice location

2945 Lincoln Dr
Roseville, MN 55113-1338

Mailing address

2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 628-3000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6249MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1306552443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 LINCOLN DR",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131338",
            "telephone_number": "651-628-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 LINCOLN DR",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131338",
            "telephone_number": "651-628-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESSMAN",
        "first_name": "JODELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.