Jessica Sue Kinnison, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013324 Issued in OH

Practice address

601 Oh - 664N
Logan, OH 43138

Phone

(740) 380-8233

Fax

(740) 385-7458

NPI assigned

Oct 2, 2024

Last updated

Oct 2, 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 1

Addresses

Other identifiers 1

Other names 1

• Jessica Sue Grandy Other name

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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1336967967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OH - 664N",
            "address_2": "PO BOX 966",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-380-8233",
            "fax_number": "740-385-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OH - 664N",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-380-8233",
            "fax_number": "740-385-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNISON",
        "first_name": "JESSICA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "013324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3978503",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GRANDY",
            "middle_name": "SUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaitlyn Marie Kilbarger
• Kindred Nursing Centers East LLC (Logan Health Care Center)
• Katherine Ann King
• Marsha King
• Susan E King, LISW
• Carol Lynn Kirk
• Leeann Kline, RPH TECH
• Emily Klucar
• Beth Kluding, QMHS
• David Knight

• Physical Therapist in Logan, OH
• Providers in Logan, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.