Andre Lamont Ross Jr.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

601 S Martin Luther King Jr Dr FL 432
Winston Salem, NC 27110-0003

Phone

(336) 750-3177

NPI assigned

Mar 22, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1124777495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S MARTIN LUTHER KING JR DR FL 432",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271100003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MARTIN LUTHER KING JR DR FL 432",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271100003",
            "telephone_number": "336-750-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ANDRE",
        "middle_name": "LAMONT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyssa Rosenberg, LCSW
• Robin Brandon Rosenbleeth, M.D.
• Nancy Smukler Rosenthal, MD
• Jon Scott Rosnes, M.D.
• Adia Kamali Ross, M.D., MHA
• Dennis Warren Ross, MD
• Diana Ross
• Gregory Allen Ross, MD
• Robert Mitchell Ross, M.D.
• Vernon Horace Ross, MD

• Athletic Trainer in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.