Southeastern Sportsmedicine

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0739 Issued in NC

Legal business name

SOUTHEASTERN SPORTSMEDICINE

Practice address

23 Turtle Creek Dr
Asheville, NC 28803-3152

Phone

(828) 274-4555

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Al Wallace

Title

Ceo

Phone

(828) 274-4555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952431645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 EMMA DR",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287869006",
            "telephone_number": "828-452-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 TURTLE CREEK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033152",
            "telephone_number": "828-274-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN SPORTSMEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-274-4555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "0739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Austin South, MD
• Jessica Southard, OTR/L
• Southeastern Medical Case Management & Rehab Services, Inc
• Southeastern Physical Therapy, LLC
• Southeastern Sports Medicine PLLC
• Southeastern United Care,LLC
• Robin A Southecorvo, OTRL
• Southern Assisted Living, LLC.
• Southern Diagnostic Imaging, Inc.
• Southern Highlands Psychological Associates PA

• Athletic Trainer in Asheville, NC
• Providers in Asheville, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.