Tessa Valdez, MS, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

096003918 Issued in IL

Practice address

2600 W Main St
Belleville, IL 62226-6651

Phone

(618) 239-6109

NPI assigned

Jan 6, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1841688496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 ROBERT AVE APT 2N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093867",
            "telephone_number": "636-667-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622266651",
            "telephone_number": "618-239-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "TESSA",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "IL",
            "license": "096003918",
            "primary": true
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MO",
            "license": "2013005311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urological Associates of Belleville Il LTD
• Ahsan Usman, MD
• Sana Usman, M.D.
• Paul Jack Utsler
• Nnenna Louisa Uzodi, MD, MPH
• Ashleigh Lia Marie Valerius, SSP, NCSP
• Pamela Ann Van Bevern, PA-C, MPAS
• Carla Jean Vandenburgh, MASSAGE THERAPIST
• Raymond Glenn Varnum, RPH
• Vasantha Pai M.D. P.C.

• Sports Medicine (Emergency Medicine) Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Sports Medicine (Emergency Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.