Jeffrey Cruz Castillo, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

720 George Hege Rd
Lexington, NC 27295-9023

Phone

(336) 470-8874

NPI assigned

Jan 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Cruz Castillo Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1497460778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 GEORGE HEGE RD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272959023",
            "telephone_number": "336-470-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GEORGE HEGE RD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272959023",
            "telephone_number": "336-470-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ CASTILLO",
        "first_name": "JEFFREY",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRUZ",
            "last_name": "CASTILLO",
            "credential": "LAT, ATC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Athletic Trainer in Lexington, NC
• Providers in Lexington, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.