Leah Nissle, MA, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT005715 Issued in PA

Practice address

3141 Chestnut St
Philadelphia, PA 19104-2875

Phone

(215) 895-1597

NPI assigned

Jul 10, 2019

Last updated

Jul 10, 2019By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1497307433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042875",
            "telephone_number": "215-895-1597",
            "fax_number": "215-895-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042875",
            "telephone_number": "215-895-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSLE",
        "first_name": "LEAH",
        "credential": "MA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT005715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Noelle Nisenzon, PH.D.
• Wataru Nishida, MS, NCC, LPC
• Taiki Nishihara, MD
• Shaina Nishimura, AU.D.
• Akira Nishisaki, MD
• Jenelle D. Nissley-Tsiopinis, PH.D.
• Frederick P Nissley, DO
• Kristine Nissley, CRNP
• Pichayut Nithagon, MD
• April E Nitkin, CRNP

• Athletic Trainer in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.