Individual provider Active NPI

Justin-Casey Rocha, LAT ATC

  • Athletic Trainer
  • San Antonio, TX
National Provider Identifier
1699348169
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT7430 Issued in TX
Practice address
1303 McCullough Ave
San Antonio, TX 78212-5609
Phone
(726) 666-0262
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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 AT7430 TX Primary

Addresses

Primary practice location

1303 McCullough Ave
San Antonio, TX 78212-5609

Mailing address

7719 Westlyn Dr
San Antonio, TX 78227-2633

Other identifiers 1

IdentifierTypeStateIssuer
7430OtherTXBLUECROSS BLUESHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL HorizonWebRef

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
AT7430TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1699348169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7719 WESTLYN DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782272633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125609",
            "telephone_number": "726-666-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHA",
        "first_name": "JUSTIN-CASEY",
        "credential": "LAT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "7430",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HorizonWebRef",
            "affiliation": "N",
            "address_1": "1303 McCullough Ave",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782125609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.