Nicole Ruth Jessen, MS, ATC, LAT, PES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003428 Issued in OH

Practice address

2830 Napoleon Rd
Fremont, OH 43420-9814

Phone

(419) 559-2100

NPI assigned

Mar 15, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1982903027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 ELMONT RD APT 2",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151478",
            "telephone_number": "440-554-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 NAPOLEON RD",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209814",
            "telephone_number": "419-559-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "NICOLE",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "MS, ATC, LAT, PES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "AT.003428",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9279",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT003428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Stierwalt, M.D.
• Lindsay James, LISW
• Jamie Hoppe
• Monica Sue Jay, LISW-S
• Angela R Jeffries, RPH
• Mandi Elizabeth Jester, MSW, LSW
• Jaclyn Noel Marie Jezak, CNP
• John J. Clarke, D.P.M.
• Stephanie Johnson, LPC
• Jonathan F. Diller, M.D., Inc.

• Athletic Trainer in Fremont, OH
• Providers in Fremont, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.