Individual provider Active NPI

Alyssa R Myatt, ATC, VAT,L

  • Athletic Trainer
  • Virginia Beach, VA
National Provider Identifier
1427366533
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001536 Issued in VA
Practice address
1300 Sentara Park
3Rd Floor
Virginia Beach, VA 23464
Phone
(757) 252-3050
Fax
(757) 223-1062
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 0126001536 VA Primary

Addresses

Primary practice location

1300 Sentara Park
3Rd Floor
Virginia Beach, VA 23464

Mailing address

1300 Sentara Park
3Rd Floor
Virginia Beach, VA 23464
Phone (757) 252-3050

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

LicenseStateTypeSpecialty
0126001536VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1427366533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SENTARA PARK",
            "address_2": "3RD FLOOR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23464",
            "telephone_number": "757-252-3050",
            "fax_number": "757-223-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SENTARA PARK",
            "address_2": "3RD FLOOR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23464",
            "telephone_number": "757-252-3050",
            "fax_number": "757-223-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYATT",
        "first_name": "ALYSSA",
        "middle_name": "R",
        "credential": "ATC, VAT,L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.