Active NPI
Alexis Toni Villanueva, ATC
- Athletic Trainer
- Lock Haven, PA
National Provider Identifier
1366711772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT005066
- Practice address
- 401 N Fairview St
Health Professions Building
Lock Haven, PA 17745-2342 - Phone
- (570) 484-2878
- Fax
- (750) 484-2200
- NPI assigned
- Dec 14, 2011
- Sex
- Female
- 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 | RT005066 | PA | Primary |
Addresses
Primary practice location
401 N Fairview St
Health Professions Building
Lock Haven, PA 17745-2342
Mailing address
401 N Fairview St
Health Professions Building
Lock Haven, PA 17745-2342
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
| License | State | Type | Specialty |
|---|---|---|---|
| RT005066 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1366711772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 N FAIRVIEW ST",
"address_2": "HEALTH PROFESSIONS BUILDING",
"city": "LOCK HAVEN",
"state": "PA",
"postal_code": "177452342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N FAIRVIEW ST",
"address_2": "HEALTH PROFESSIONS BUILDING",
"city": "LOCK HAVEN",
"state": "PA",
"postal_code": "177452342",
"telephone_number": "570-484-2878",
"fax_number": "750-484-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "ALEXIS",
"middle_name": "TONI",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-14",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT005066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lock Haven, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.