Active NPI
Alesha Joy Landis
- Athletic Trainer
- Edmond, OK
National Provider Identifier
1134341829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1800 Renaissance Blvd
Second Floor
Edmond, OK 73013-3023 - Phone
- (405) 359-2472
- NPI assigned
- May 3, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | OK | Primary |
Addresses
Primary practice location
1800 Renaissance Blvd
Second Floor
Edmond, OK 73013-3023
Mailing address
928 Royal Way
Edmond, OK 73034-5515
Phone (405) 249-0907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2255A2300X | Other | OK | SOLE PROVIDER |
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 |
|---|---|---|---|
| 081361617 | OK | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134341829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 ROYAL WAY",
"city": "EDMOND",
"state": "OK",
"postal_code": "730345515",
"telephone_number": "405-249-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 RENAISSANCE BLVD",
"address_2": "SECOND FLOOR",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133023",
"telephone_number": "405-359-2472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDIS",
"first_name": "ALESHA",
"middle_name": "JOY",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOLE PROVIDER",
"identifier": "2255A2300X",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.