Jeancarlo Alencastro, ATC/L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT001665 Issued in GA

Practice address

777 Cleveland Ave SW Suite 406
Atlanta, GA 30315-7101

Phone

(404) 228-3112

Fax

(404) 763-0135

NPI assigned

Jan 7, 2010

Last updated

Jan 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• South Fulton Medical Center, LLC

  dba south fulton medical center

  • Rehabilitation Chiropractor
  • Atlanta, GA
  • NPI 1225204423
  NPD (past)

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1891025235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 B VALLEYWOOD RD",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "30290",
            "telephone_number": "678-852-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW SUITE 406",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157101",
            "telephone_number": "404-228-3112",
            "fax_number": "404-763-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALENCASTRO",
        "first_name": "JEANCARLO",
        "credential": "ATC/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddy Francisco Aleman, PA-C
• Karla Aleman, RD, LD
• Luis Aleman
• Ruth Kebede Alemu
• Yared Alemu, PH.D.
• Alera Care Specialty and Infusion Center
• Olatunji B. Alese, M.D.
• Lana Aleuy
• Alex Cole DMD LLC (Coggin Dental Group)
• Alex E. Rikhter, MD P.C.

• Athletic Trainer in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.