Individual provider Active NPI

Alfredo Alejandro Mosquera Nino, LAT, ATC

  • Athletic Trainer
  • College Station, TX
National Provider Identifier
1467909119
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT8611 Issued in TX
Practice address
1228 Tamu
College Station, TX 77843-3370
Phone
(979) 845-3121
NPI assigned
Sep 9, 2016
Last updated
May 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 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 AT8611 TX Primary

Addresses

Primary practice location

1228 Tamu
College Station, TX 77843-3370

Mailing address

3780 Copperfield Dr Apt 813
Bryan, TX 77802-5886
Phone (330) 245-7982

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
AT8611TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1467909119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 COPPERFIELD DR APT 813",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025886",
            "telephone_number": "330-245-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 TAMU",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778433370",
            "telephone_number": "979-845-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUERA NINO",
        "first_name": "ALFREDO",
        "middle_name": "ALEJANDRO",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-09",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.