Individual provider Active NPI

Jessica Edler, PHD, LAT, ATC

  • Athletic Trainer
  • Des Moines, IA
National Provider Identifier
1427465020
Registry record updated Aug 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
088455 Issued in IA
Practice address
1200 Grandview Ave
Des Moines, IA 50316
Phone
(515) 263-6078
NPI assigned
Jul 15, 2014
Last updated
Aug 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 088455 IA Primary

Addresses

Primary practice location

1200 Grandview Ave
Des Moines, IA 50316

Mailing address

3164 SW Arlan LN
Ankeny, IA 50023-6826

Other practice location 1

567 N 5th St
Sycamore Wellness and Applied Medicine Center
Terre Haute, IN 47809-1903
Phone (563) 357-8366

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
088455IAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1427465020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 SW ARLAN LN",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500236826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANDVIEW AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50316",
            "telephone_number": "515-263-6078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "567 N 5th St",
            "address_2": "Sycamore Wellness and Applied Medicine Center",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478091903",
            "country_code": "US",
            "telephone_number": "563-357-8366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDLER",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PHD, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "088455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; 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.