Individual provider Active NPI

Jason Alexander Doctor, ATC

  • Athletic Trainer
  • Richmond, VA
National Provider Identifier
1730492562
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001080 Issued in VA
Practice address
500 Hioaks Rd
Richmond, VA 23225-4061
Phone
(804) 560-6500
NPI assigned
Jul 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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 0126001080 VA Primary

Addresses

Primary practice location

500 Hioaks Rd
Richmond, VA 23225-4061

Mailing address

1200 Normandy Dr
Richmond, VA 23229-6711

Other identifiers 1

IdentifierTypeStateIssuer
22OtherVAREHABILITATION

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
0126001080VAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Chippenham and Johnston-Willis Sports Medicine, LLC Past Accepting new patients
Primary Health Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1730492562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORMANDY DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HIOAKS RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254061",
            "telephone_number": "804-560-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REHABILITATION",
            "identifier": "22",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.