Juan Carlos Simon Villegas Gomez, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1081 John Robert Bell Dr
Johnson City, TN 37601

Phone

(423) 439-4044

NPI assigned

Nov 19, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  NPD (past)

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1396381992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E MOUNTAIN VIEW RD APT 804",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011279",
            "telephone_number": "786-252-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 JOHN ROBERT BELL DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-439-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS GOMEZ",
        "first_name": "JUAN CARLOS",
        "middle_name": "SIMON",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Orthotics & Prosthetics LLC
• Victory Vision, PLLC
• Meaghan Marie Viggiani, MA
• Michael Bryanne Villalba
• Jose Villanueva, PT
• Elizabeth A Villier, CRNA
• Alexa Marie Vincent, NP
• Rachael Marie Vines, BS
• Elizabeth M. Virost, FNP
• Kevin Charles Visconti, M.D.

• Athletic Trainer in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.