Jodi Marak Ouellette, ATC
Individual provider Active NPI Athletic Trainer · Westbrook, CT
NPI 1831463785 · NPPES record last updated Feb 23, 2012
Key facts
- NPI
- 1831463785
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 000189 (CT)
- Practice address
- 5 Pequot Park Rd
Suite 303
Westbrook, CT 06498-2856 - Phone
- (860) 399-6411
- NPI assigned
- Feb 23, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000189 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norwich Orthopedic Group, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000189 | CT | Yes |
Addresses
Primary practice location
5 Pequot Park Rd
Suite 303
Westbrook, CT 06498-2856
Mailing address
867 W Pond Meadow Rd
Westbrook, CT 06498-2836
Other providers in Westbrook, CT
- Jeong Eun Oh
- Orthopaedic & Neurosurgery Specialists, PLLC
- Orthopaedic & Neurosurgery Specialists, PLLC
- Orthopedic Associates of Middletown, PC
- Melissa Ortiz-Sinclair
- Timothy Ouellette
- Jason M Palana
- Rinkesh A Patel
- Suhani Patel
- Peter J Patten
All providers in Westbrook, CT · Athletic Trainer in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.