Active NPI
Alexa Erin Dehaeseleer
- Athletic Trainer
- Bradenton, FL
National Provider Identifier
1497264303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1701 27TH St E
Bradenton, FL 34208-7831 - Phone
- (818) 447-2663
- NPI assigned
- Sep 22, 2017
- 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 | Primary |
Addresses
Primary practice location
1701 27TH St E
Bradenton, FL 34208-7831
Mailing address
17555 Nordhoff St
Northridge, CA 91325-2902
Phone (818) 447-2663
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | PC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644710400000",
"number": "1497264303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17555 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913252902",
"telephone_number": "818-447-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 27TH ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342087831",
"telephone_number": "818-447-2663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHAESELEER",
"first_name": "ALEXA",
"middle_name": "ERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-22",
"last_updated": "2022-02-13",
"certification_date": "2022-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "PC",
"affiliation": "N",
"address_1": "1701 27th St E",
"city": "Bradenton",
"state": "FL",
"country_code": "US",
"postal_code": "342087831",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.