Johanna Renee Urquijo, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1354 Issued in AZ

Practice address

12775 E Mary Ann Cleveland Way
Vail, AZ 85641-8600

Phone

(520) 602-8266

NPI assigned

Dec 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: islasj@vailschooldistrict.org

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1003454869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6282 S TRUTH PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857466282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12775 E MARY ANN CLEVELAND WAY",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418600",
            "telephone_number": "520-602-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URQUIJO",
        "first_name": "JOHANNA",
        "middle_name": "RENEE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Islasj@vailschooldistrict.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12775 E Mary Ann Cleveland Way",
            "city": "Vail",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "856418600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Vail Unified School District
• Carol Vallecalle

• Athletic Trainer in Vail, AZ
• Providers in Vail, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.