Active NPI
Joshua Howard Fallin, LAT, ATC
- Athletic Trainer
- Winston-Salem, NC
National Provider Identifier
1023006608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0669
- Practice address
- 401 Deacon Blvd
Winston-Salem, NC 27105-4216 - Phone
- (336) 759-7200
- NPI assigned
- Oct 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0669 | NC | Primary |
Addresses
Primary practice location
401 Deacon Blvd
Winston-Salem, NC 27105-4216
Mailing address
270 Summerglen Dr
Lewisville, NC 27023-8236
Phone (336) 946-0322
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0669 | NC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023006608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 SUMMERGLEN DR",
"city": "LEWISVILLE",
"state": "NC",
"postal_code": "270238236",
"telephone_number": "336-946-0322",
"fax_number": "336-946-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 DEACON BLVD",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271054216",
"telephone_number": "336-759-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLIN",
"first_name": "JOSHUA",
"middle_name": "HOWARD",
"name_prefix": "Mr.",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "0669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.