Individual provider Active NPI

Addison Lela Helton-Iliria, MAT, LAT,ATC

  • Athletic Trainer
  • Dallas, TX
National Provider Identifier
1104635036
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT9759 Issued in TX
Practice address
5800 Ownby Drive
Dallas, TX 75205
Phone
(619) 884-3530
Fax
(214) 768-1225
NPI assigned
Jan 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT9759 TX Primary

Addresses

Primary practice location

5800 Ownby Drive
Dallas, TX 75205

Mailing address

5800 Ownby Drive
Dallas, TX 75205
Phone (619) 884-3530

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

LicenseStateTypeSpecialty
AT9759TXMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Methodist University PastSince Jan 12, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1104635036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 OWNBY DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "619-884-3530",
            "fax_number": "214-768-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 OWNBY DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "619-884-3530",
            "fax_number": "214-768-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELTON-ILIRIA",
        "first_name": "ADDISON",
        "middle_name": "LELA",
        "credential": "MAT, LAT,ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.