Healthcare Provider Details

I. General information

NPI: 1023975232
Provider Name (Legal Business Name): JESSICA FOOTE MS, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 BURRSTONE RD
UTICA NY
13502-4857
US

IV. Provider business mailing address

6807 LOWELL RD
ROME NY
13440-1228
US

V. Phone/Fax

Practice location:
  • Phone: 315-792-3124
  • Fax: 315-223-2403
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number004715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: