Jesse Tittle, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

261106063 Issued in IN

Practice address

1100 Reid Pkwy
Richmond, IN 47374-1157

Phone

(765) 983-3092

NPI assigned

Oct 17, 2016

Sex

Male

Sole proprietor

Yes

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

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1396296109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N 5TH ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473743013",
            "telephone_number": "563-357-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITTLE",
        "first_name": "JESSE",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "261106063",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT003116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Tincher
• Tinkle Chiropractic, Inc.
• Jonathan Kelly Tinkle, DC
• Soumya R Tippireddy, DO, MBA
• Jadalynn Tipton
• William H. Toedebusch, M.D.
• Gabor L Tolnay, MD
• Karen A Tomlin, RBT
• Sumeet Toor, MD
• John Toschlog

• Athletic Trainer in Richmond, IN
• Providers in Richmond, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.