Jennifier R Johnsrud, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

310-06 Issued in ND

Practice address

2400 32ND Ave S
Sports Medicine
Fargo, ND 58122-0001

Phone

(701) 234-7911

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifier R Preston Former 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558448373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 34TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565606937",
            "telephone_number": "701-388-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S",
            "address_2": "SPORTS MEDICINE",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220001",
            "telephone_number": "701-234-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSRUD",
        "first_name": "JENNIFIER",
        "middle_name": "R",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": "310-06",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFIER",
            "last_name": "PRESTON",
            "middle_name": "R",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terryl L Johnson, APRN,CNP
• Therese Johnson, MD
• Walter S Johnson, MD
• Whitney Renae Johnson, MSN, PMHNP-BC, PMH-C
• William A Johnson, D.D.S.
• Betty Jo Johnston, BS OT
• Heather Marie Johnston, M.S.
• Liane Marie Johnston, LPN
• Ryan Johnston, CPO
• Jon Norberg MD PC (Advanced Hand and Upper Extremity Clinic)

• Athletic Trainer in Fargo, ND
• Providers in Fargo, ND by specialty
• Athletic Trainer in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.