Individual provider Active NPI

Alyssa Dall, AT, ATC

  • Athletic Trainer
  • Grosse Pointe Woods, MI
National Provider Identifier
1134828338
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601002921 Issued in MI
Practice address
564 Glen Arbor LN
Grosse Pointe Woods, MI 48236-1506
Phone
(313) 316-9890
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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 2601002921 MI Primary

Addresses

Primary practice location

564 Glen Arbor LN
Grosse Pointe Woods, MI 48236-1506

Mailing address

564 Glen Arbor LN
Grosse Pointe Woods, MI 48236-1506
Phone (313) 316-9890

Other practice location 1

564 Glen Arbor Ln
Grosse Pointe Woods, MI 48236-1506
Phone (313) 316-9890

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
2601002921MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1134828338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 GLEN ARBOR LN",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361506",
            "telephone_number": "313-316-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 GLEN ARBOR LN",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361506",
            "telephone_number": "313-316-9890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "564 Glen Arbor Ln",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe Woods",
            "state": "MI",
            "postal_code": "482361506",
            "country_code": "US",
            "telephone_number": "313-316-9890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALL",
        "first_name": "ALYSSA",
        "credential": "AT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601002921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.