Callie Lynn Yensen, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT004248 Issued in OH

Practice address

4605 Sawmill Rd
Upper Arlington, OH 43220-2246

Phone

(614) 827-8655

NPI assigned

Jan 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Callie Lynn Jedrzejek 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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1689110991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 INTERLACHEN DR. APT.A",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "43026",
            "telephone_number": "440-864-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 SAWMILL RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202246",
            "telephone_number": "614-827-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENSEN",
        "first_name": "CALLIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT004248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "JEDRZEJEK",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Gambril Williams, DPT
• Annette Gina Wittine, PT
• Shelby Russell Wolf, MSN, APRN, FNP-BC
• Claire V Wolfe, MD
• Erica Yumi Yamamoto, DO
• Shimboon Yoon, L.AC.
• Colleen Janel Young, CNP
• Charles Roger Zody II, D.D.S.

• Athletic Trainer in Upper Arlington, OH
• Providers in Upper Arlington, OH by specialty
• Athletic Trainer in Ohio

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