Active NPI
Juan Alexander Alonso, MS,LAT,ATC
- Athletic Trainer
- Baxley, GA
National Provider Identifier
1194283713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT002830
- Practice address
- 482 Blackshear Hwy
Baxley, GA 31513-6708 - Phone
- (912) 367-8610
- Fax
- (912) 366-9877
- NPI assigned
- Mar 4, 2019
- Last updated
- Mar 4, 2019
- Sex
- Male
- Sole proprietor
- No
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 | AT002830 | GA | Primary |
Addresses
Primary practice location
482 Blackshear Hwy
Baxley, GA 31513-6708
Mailing address
1258 Sunset Blvd Apt 1F
Jesup, GA 31545-7802
Phone (404) 434-2171
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT002830 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551657600000",
"number": "1194283713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1258 SUNSET BLVD APT 1F",
"city": "JESUP",
"state": "GA",
"postal_code": "315457802",
"telephone_number": "404-434-2171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "482 BLACKSHEAR HWY",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315136708",
"telephone_number": "912-367-8610",
"fax_number": "912-366-9877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALONSO",
"first_name": "JUAN",
"middle_name": "ALEXANDER",
"credential": "MS,LAT,ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-04",
"last_updated": "2019-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT002830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxley, GA
- 912 Healthcare, LLC
- Josefina Cathryn Abendan Dubberly, M.D.
- Abundant Life Pharmacy & Health Foods Inc (Abundant Life Pharmacy and Health Foods Inc)
- Abundant Life Pharmacy & Health Foods Inc
- Jessica Marie Alferink, FNP
- Altamaha Homecare, Inc.
- Altamaha Homecare, Inc.
- Altamaha Homecare, Inc.
- Caroline Anderson, FNP
- Angels With Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.