Alexandra Elizabeth Vladyka, DAT, LAT, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATR-008903 Issued in AZ

Practice address

3100 S. Craycroft Road
79TH Squadron
Tucson, AZ 85707

Phone

(425) 508-4948

NPI assigned

Apr 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexandra Elizabeth Bryan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1912351529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 E VIA ARROYO LARGO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857568392",
            "telephone_number": "425-508-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S. CRAYCROFT ROAD",
            "address_2": "79TH SQUADRON",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85707",
            "telephone_number": "425-508-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLADYKA",
        "first_name": "ALEXANDRA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DAT, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATR-008903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "BRYAN",
            "middle_name": "ELIZABETH",
            "credential": "MS, LAT, CSCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Julie Ngoc Vo, DMD

• Athletic Trainer in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.