Jessica Lynn Wassel, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19661 Issued in NC

Practice address

1300 Corporation Pkwy Ste B
Raleigh, NC 27610-1362

Phone

(919) 917-7729

NPI assigned

Dec 6, 2019

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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.

• Revive Boost Rebuild Physical Therapy LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1194192294
  Medicare reassignment NPD

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1922645126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRATTON DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297825",
            "telephone_number": "919-917-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CORPORATION PKWY STE B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101362",
            "telephone_number": "919-917-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSEL",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Wasikowski, LCSW
• Mariam Wasim, MD
• Shaylyn Wasko
• Hannah Waspi, MS, RD, LDN
• Jenelle Wass, MS, RD, LDN
• Matthew R Wassel, D.D.S.
• Bradley Jared Wasserman, M.D.
• Christine Wassmuth, LCSW
• Harpreet Kaur Wasson, DDS
• Nikunj Wasudev, MD

• Physical Therapist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.