Alexander L Avallon Jr., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT001279A Issued in PA

Practice address

414 Commerce Dr
Suite 130 Temple Sports Medicine
Fort Washington, PA 19034-2618

Phone

(215) 641-0700

Fax

(215) 641-0637

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By 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

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962546804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 COMMERCE DR",
            "address_2": "SUITE 130 TEMPLE SPORTS MEDICINE",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342618",
            "telephone_number": "215-641-0700",
            "fax_number": "215-641-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 COMMERCE DR",
            "address_2": "SUITE 130 TEMPLE SPORTS MEDICINE",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342618",
            "telephone_number": "215-641-0700",
            "fax_number": "215-641-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALLON",
        "first_name": "ALEXANDER",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001279A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Fort Washington, PA
• Providers in Fort Washington, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.