Active NPI
Jessica Cordle, MS, CTRS
- Counselor
- Grove City, OH
National Provider Identifier
1336775774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 5665 Hoover Rd
Grove City, OH 43123-9280 - Phone
- (706) 969-2984
- NPI assigned
- Mar 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 65528 | ||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
5665 Hoover Rd
Grove City, OH 43123-9280
Mailing address
4078 E Bluff Dr
Lewis Center, OH 43035-9176
Phone (706) 969-2984
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1336775774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4078 E BLUFF DR",
"city": "LEWIS CENTER",
"state": "OH",
"postal_code": "430359176",
"telephone_number": "706-969-2984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 HOOVER RD",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431239280",
"telephone_number": "706-969-2984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDLE",
"first_name": "JESSICA",
"credential": "MS, CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-17",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": "65528",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grove City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.