Active NPI
Justin Allen Valentine, BS, ATC, LAT
- Athletic Trainer
- Vestal, NY
National Provider Identifier
1558095794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 004264
- Practice address
- 4433 Vestal Pkwy E
Vestal, NY 13850-3556 - Phone
- (607) 771-2220
- NPI assigned
- Jul 13, 2022
- Sex
- Male
- 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 | 004264 | NY | Primary |
Addresses
Primary practice location
4433 Vestal Pkwy E
Vestal, NY 13850-3556
Mailing address
PO Box 273
Downsville, NY 13755-0273
Phone (607) 386-5772
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004264 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1558095794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 273",
"city": "DOWNSVILLE",
"state": "NY",
"postal_code": "137550273",
"telephone_number": "607-386-5772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4433 VESTAL PKWY E",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503556",
"telephone_number": "607-771-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTINE",
"first_name": "JUSTIN",
"middle_name": "ALLEN",
"credential": "BS, ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-13",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "004264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.