Active NPI
Alex Kendrick Black, ATC
- Athletic Trainer
- Blacksburg, VA
National Provider Identifier
1083124556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126002567
- Practice address
- 150 Jamerson Center (0502) 21 Beamer Way
Blacksburg, VA 24061-0001 - Phone
- (540) 231-6410
- NPI assigned
- Oct 10, 2017
- Last updated
- Oct 10, 2017
- 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 | 0126002567 | VA | Primary |
Addresses
Primary practice location
150 Jamerson Center (0502) 21 Beamer Way
Blacksburg, VA 24061-0001
Mailing address
834 Patrick Henry Dr
Blacksburg, VA 24060-3141
Phone (513) 728-1141
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 |
|---|---|---|---|
| 0126002567 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1083124556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 PATRICK HENRY DR",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240603141",
"telephone_number": "513-728-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 JAMERSON CENTER (0502) 21 BEAMER WAY",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240610001",
"telephone_number": "540-231-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "ALEX",
"middle_name": "KENDRICK",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-10",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126002567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, VA
- Victoria Hutchins Bierman, PMHNP
- Bio-Medical Applications of Virginia, Inc. (FMC Dialysis Services Montgomery County)
- Zachary Logan Birch, DO
- Benjamin James Bishop, DDS
- Thomas H Bishop, M.D.
- Blacksburg Behavioral Health, LLC
- Blacksburg Center for Pain Management, Inc.
- Blacksburg Family Care LLC
- Blacksburg Internal Medicine and Cardiology
- Blacksburg Life Care, LLC (Heritage Hall - Blacksburg)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.