Individual provider Active NPI

Jessica Nicole Peters, AT

  • Athletic Trainer
  • Cincinnati, OH
National Provider Identifier
1992834113
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT002824 Issued in OH
Practice address
5589 Cheviot Rd
Cincinnati, OH 45247-7020
Phone
(513) 245-5434
Fax
(513) 245-5437
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT002824 OH Primary

Addresses

Primary practice location

5589 Cheviot Rd
Cincinnati, OH 45247-7020

Mailing address

4701 Creek Rd
Suite 110
Cincinnati, OH 45242-8398
Phone (513) 733-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT002824OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1992834113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 CREEK RD",
            "address_2": "SUITE 110",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452428398",
            "telephone_number": "513-733-9333",
            "fax_number": "513-588-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5589 CHEVIOT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477020",
            "telephone_number": "513-245-5434",
            "fax_number": "513-245-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "AT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT002824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.