Active NPI
Rasheyd Raza Jesse Bevalian, LAT, ATC
- Athletic Trainer
- Sierra Vista, AZ
National Provider Identifier
1043977309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATR-100140
- Practice address
- 81501 Bissel St
Sierra Vista, AZ 85613 - Phone
- (520) 454-7593
- NPI assigned
- Nov 22, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Athletic Trainer | 2255A2300X | AT9025 | TX | |
| Athletic Trainer | 2255A2300X | ATR-100140 | AZ | Primary |
Addresses
Primary practice location
81501 Bissel St
Sierra Vista, AZ 85613
Mailing address
2240 Winrow Rd
Fort Huachuca, AZ 85613-5080
Phone (520) 533-9200
Other practice location 1
3300 W Camelback Rd
Phoenix, AZ 85017-1097
Phone (602) 741-8642
Other practice location 2
21275 Light Infantry Ave
El Paso, Ft. Bliss, TX 79908-7990
Phone (915) 257-9909
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 |
|---|---|---|---|
| ATR-100140 | AZ | MD | Athletic Trainer |
| AT9025 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1043977309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 WINROW RD",
"city": "FORT HUACHUCA",
"state": "AZ",
"postal_code": "856135080",
"telephone_number": "520-533-9200",
"fax_number": "520-533-5246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81501 BISSEL ST",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "85613",
"telephone_number": "520-454-7593"
}
],
"practiceLocations": [
{
"address_1": "3300 W Camelback Rd",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850171097",
"country_code": "US",
"telephone_number": "602-741-8642",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "21275 Light Infantry Ave",
"address_purpose": "LOCATION",
"city": "El Paso, Ft. Bliss",
"state": "TX",
"postal_code": "799087990",
"country_code": "US",
"telephone_number": "915-257-9909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEVALIAN",
"first_name": "RASHEYD",
"middle_name": "RAZA JESSE",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-22",
"last_updated": "2024-10-01",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT9025",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "ATR-100140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.