Jessica Tabatt, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

928 Issued in MN

Practice address

2024 S 6TH St
Brainerd, MN 56401-4529

Phone

(218) 828-7110

NPI assigned

Jun 17, 2012

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Joseph'S Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
  • NPI 1568415974
  Medicare reassignment NPD
• St Joseph'S Medical Center

  • Multi-Specialty Clinic/Center
  • Staples, MN
  • NPI 1538916101
  NPD
• St. Joseph'S Medical Center

  • Multi-Specialty Clinic/Center
  • Emily, MN
  • NPI 1538571914
  NPD

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1811250707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-829-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-828-7110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Barclay Ave",
            "address_purpose": "LOCATION",
            "city": "Pine River",
            "state": "MN",
            "postal_code": "564745139",
            "country_code": "US",
            "telephone_number": "218-587-4416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABATT",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "TP187",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karie Lynn Svoboda, LPCC
• Brooke Ann Swanson, MS, LPCC
• Carrie Ann Swanson, WHNP
• Taylor Jay Swanson, OD
• Katie Jene Garrey Swenson, MS, LPCC
• Philip B Tange, MSW
• Natasha N Tanner
• Tyra Lee Taylor, MSW, LICSW
• Angela Mae Teckemeyer, APRN, DNP
• Telic Family Chiropractic

• Foot & Ankle Surgery Podiatrist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Foot & Ankle Surgery Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.