Alexander John Smith, MAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36003781A Issued in IN

Practice address

517 Ball Dr
Hanover, IN 47243-9648

Phone

(224) 256-3025

NPI assigned

Dec 13, 2024

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1023825072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BALL DR",
            "city": "HANOVER",
            "state": "IN",
            "postal_code": "472439648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 BALL DR",
            "city": "HANOVER",
            "state": "IN",
            "postal_code": "472439648",
            "telephone_number": "224-256-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALEXANDER",
        "middle_name": "JOHN",
        "credential": "MAT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT2206",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003781A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kobie Roy, DPT
• Tamara Royalty, FNP-C
• Mary Schroeder
• Sarah Margaret Sexson, MSN, FNP-C
• Dawn Kathleen Sirek, FNP-C
• Kristen Smith
• Southwestern Jefferson County Consolidated School Corporation
• David Spaulding, OTR
• Angela J Watson, P.T.
• Amanda Watts, RN

• Athletic Trainer in Hanover, IN
• Providers in Hanover, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.