Jillian Allyn Riessen, M.ED., ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2011028500 Issued in MO

Practice address

3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517

Phone

(573) 449-8771

NPI assigned

Oct 17, 2016

Last updated

Oct 17, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1831640614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR STE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR STE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESSEN",
        "first_name": "JILLIAN",
        "middle_name": "ALLYN",
        "credential": "M.ED., ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2011028500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Steven Riebe, D.O.
• Kimberly Jean Riebe, FNP/MSN
• Allison Riechmann, PHARMD
• Frank G Rieger, MD
• David R Ries, DDS
• Zack Riessen, M.ED., ATC, LAT
• Colin Alexander Rieth
• Kasem Rifai, MD
• Danita G Rife, A.P.R.N.
• Emily Margaret Rife, MD

• Athletic Trainer in Columbia, MO
• Providers in Columbia, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.