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

LicenseStateTypeSpecialty
AT03299SCMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2000050675OtherBOC CERTIFICATION NUMBER

Other providers in Greenville, SC

All providers in Greenville, SC · Athletic Trainer in South Carolina

Sources for this page

Verify at the official NPI Registry.