JILLIAN ALLISON TESLOW RICKERTSEN (NPI# 1811423460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811423460 |
| Entity Type | Individual |
| Full Name | JILLIAN ALLISON TESLOW RICKERTSEN |
| Credential | D.P.M. |
| Practice Address |
734 W Main St Ste 100 Louisville KY 40202-3687 |
| Mailing Address |
427 Us 31w Byp Ste 202 Bowling Green KY 42101-1703 |
| Practice Telephone | 5028044811 |
| Mailing Telephone | 2707966160 |
| Mailing Fax Number | 2709045774 |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2020-06-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
263056 | KY | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11800 E 12 Mile Rd, Warren, MI 480933472 | 2489677607 |
| Street Address |
734 W MAIN ST STE 100 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-3687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821651852 | Sports Medicine Surgical Specialists Pllc | Podiatrist | 309 Guthrie St, Louisville, KY 40202-1813 | 2019-04-16 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1992239214 | Nathaniel Winters | Podiatrist | 6801 Dixie Hwy Ste 134, Louisville, KY 40258-3952 | 2017-04-13 |
| 1992188437 | Brett P Vessell | Podiatrist | 4119 Browns Ln Ste 2, Louisville, KY 40220-1500 | 2015-07-01 |
| 1629286257 | Adam Alexander Didyk | Podiatrist | 13105 Eastpoint Park Blvd, Louisville, KY 40223 | 2007-05-18 |
| 1699803270 | Gerardo Ulfe | Podiatrist | 317b Guthrie Grn, Louisville, KY 40202 | 2007-03-02 |
| 1164512612 | Brian T Przystawski, Dpm, PCs | Podiatrist | 4119 Browns Lane, Bld#2, Louisville, KY 40220 | 2006-10-13 |
| 1821023250 | Judy Nonglak Outsa | Podiatrist | 6407 Preston Hwy, Suite #1, Louisville, KY 40219-1850 | 2006-07-12 |
| 1053353607 | Rhonda A Eichenberger | Podiatrist | 9900 Shelbyville Rd Ste 11a, Louisville, KY 40223-2965 | 2006-06-11 |
| 1023057072 | Podiatric Physicians of Kentucky, Psc | Podiatrist | 9110 Leesgate Road, Louisville, KY 40222 | 2006-06-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
Please comment or provide details below to improve the information on JILLIAN ALLISON TESLOW RICKERTSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.