Active NPI
Jennie Sertterh, ATC
- Athletic Trainer
- Iowa City, IA
National Provider Identifier
1649667734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 00207
- Practice address
- 1 Elliot Drive
S181 Carver Hawkeye Arena
Iowa City, IA 52242 - Phone
- (319) 335-9391
- NPI assigned
- Apr 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 00207 | IA | Primary |
Addresses
Primary practice location
1 Elliot Drive
S181 Carver Hawkeye Arena
Iowa City, IA 52242
Mailing address
1 Elliot Drive
S181 Carver Hawkeye Arena
Iowa City, IA 52242
Phone (319) 335-9391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | RESPIRATORY, REHABILITATIVE, AND RESTORATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00207 | IA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429142400000",
"number": "1649667734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ELLIOT DRIVE",
"address_2": "S181 CARVER HAWKEYE ARENA",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52242",
"telephone_number": "319-335-9391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ELLIOT DRIVE",
"address_2": "S181 CARVER HAWKEYE ARENA",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52242",
"telephone_number": "319-335-9391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERTTERH",
"first_name": "JENNIE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-16",
"last_updated": "2015-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "00207",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, REHABILITATIVE, AND RESTORATION",
"identifier": "22",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.