Active NPI
Alexandra Johnson
- Athletic Trainer
- Conway, SC
National Provider Identifier
1386293173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1045
- Practice address
- 2301 Church St
Conway, SC 29526-2975 - Phone
- (843) 488-0662
- NPI assigned
- Sep 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 1045 | SC | Primary |
Addresses
Primary practice location
2301 Church St
Conway, SC 29526-2975
Mailing address
1044 Corn Husk Loop
Conway, SC 29527-6846
Phone (774) 275-1905
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 |
|---|---|---|---|
| 1045 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1386293173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 CORN HUSK LOOP",
"city": "CONWAY",
"state": "SC",
"postal_code": "295276846",
"telephone_number": "774-275-1905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 CHURCH ST",
"city": "CONWAY",
"state": "SC",
"postal_code": "295262975",
"telephone_number": "843-488-0662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ALEXANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-05",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.