Individual provider Active NPI

Jessica Cathleen Hassis, PT

  • Physical Therapist
  • Golden Valley, MN
National Provider Identifier
1740208420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7625 Issued in MN
Practice address
3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Phone
(763) 520-0506
Fax
(763) 520-0355
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7625 MN Primary
Physical Therapist 225100000X 10220 OH

Addresses

Primary practice location

3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249

Mailing address

3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Phone (763) 520-0506

Other names 1

  • Jessica Cathleen Willey Former name

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

LicenseStateTypeSpecialty
10220OHMDPhysical Therapist
7625MNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740208420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "763-520-0506",
            "fax_number": "763-520-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "763-520-0506",
            "fax_number": "763-520-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSIS",
        "first_name": "JESSICA",
        "middle_name": "CATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7625",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "10220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WILLEY",
            "middle_name": "CATHLEEN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • 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.