Individual provider Active NPI

Rossetta Avery, MBA

  • Athletic Trainer
  • Los Angeles, CA
National Provider Identifier
1346826260
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
175565 Issued in CA
Practice address
4600 Don Lorenzo Dr Apt 50
Los Angeles, CA 90008-5140
Phone
(323) 864-4424
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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 175565 CA Primary

Addresses

Primary practice location

4600 Don Lorenzo Dr Apt 50
Los Angeles, CA 90008-5140

Mailing address

4600 Don Lorenzo Dr Apt 50
Los Angeles, CA 90008-5140
Phone (323) 864-4424

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 Business Administration

State licenses

LicenseStateTypeSpecialty
175565CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1346826260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 DON LORENZO DR APT 50",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085140",
            "telephone_number": "323-864-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 DON LORENZO DR APT 50",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085140",
            "telephone_number": "323-864-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "ROSSETTA",
        "name_prefix": "Ms.",
        "credential": "MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "175565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.