Jessica Leupold, MBA, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

730 Issued in NM

Practice address

1100 S Nickel St
Deming, NM 88030-6301

Phone

(575) 312-4089

Fax

(575) 544-0918

NPI assigned

Aug 1, 2017

Sex

Female

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

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1407370406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 BLUE QUAIL RD SW",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880307727",
            "telephone_number": "575-312-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S NICKEL ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880306301",
            "telephone_number": "575-312-4089",
            "fax_number": "575-544-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUPOLD",
        "first_name": "JESSICA",
        "credential": "MBA, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George I Lafon, MD
• David P Lanoue, MD
• Amy Lawrence Simonds, CNP
• James David Lawrence, CSW
• Randy Lenhardt, CNP
• Dalia Bermudez Licon
• Edith Lima
• Lincare Inc.
• Thomas N Lindsay, MA LLLSP
• Lloyd'S Water Pal Corporation

• Athletic Trainer in Deming, NM
• Providers in Deming, NM by specialty
• Athletic Trainer in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.