Alexa P Beaumont, ATC
Individual provider Active NPI Athletic Trainer · Greenville, SC
NPI 1144848540 · NPPES record last updated Nov 2, 2022
Key facts
- NPI
- 1144848540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT03299 (SC)
- Practice address
- 3300 Poinsett Hwy
Greenville, SC 29613-1864 - Phone
- (908) 343-9231
- NPI assigned
- Jul 12, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT03299 | SC | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | AT03299 | SC | Yes |
Addresses
Primary practice location
3300 Poinsett Hwy
Greenville, SC 29613-1864
Mailing address
34 Harvest Bell LN
Taylors, SC 29687-3575
Phone (908) 343-9231
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000050675 | Other | BOC CERTIFICATION NUMBER |
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All providers in Greenville, SC · Athletic Trainer in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.