Individual provider Active NPI

Alexa Gallo, ATC

  • Athletic Trainer
  • Mooresville, NC
National Provider Identifier
1518375237
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1609 Issued in SC
Practice address
222 Mallard Way
Mooresville, NC 28117-8117
Phone
(704) 775-3032
NPI assigned
Jul 25, 2014
Last updated
Jul 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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 1609 SC Primary

Addresses

Primary practice location

222 Mallard Way
Mooresville, NC 28117-8117

Mailing address

222 Mallard Way
Mooresville, NC 28117-8117

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
1609SCMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1518375237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MALLARD WAY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MALLARD WAY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178117",
            "telephone_number": "704-775-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "ALEXA",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.