=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073439832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIE ELIZABETH ENSLINGER PT, DPT, LAT, ATC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2026
-----------------------------------------------------
Last Update Date | 06/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1131 W MAIN ST STE C
-----------------------------------------------------
City | BLUE SPRINGS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64015-3611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-229-1941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4580 BASS PRO DR APT 338
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-7720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | 24-01708
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 11-08192
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------