Active NPI
Alyssa Wheeler, MS, ATC
- Sports Medicine (Preventive Medicine) Physician
- La Verne, CA
National Provider Identifier
1982093415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Preventive Medicine) Physician
- License
- 2000017815
- Practice address
- 2280 Damien Ave
La Verne, CA 91750-5210 - Phone
- (909) 596-1946
- NPI assigned
- Jan 21, 2015
- Last updated
- Jan 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Preventive Medicine) Physician | 2083S0010X | 2000017815 | CA | Primary |
Addresses
Primary practice location
2280 Damien Ave
La Verne, CA 91750-5210
Mailing address
9327 Agave Dr
Hesperia, CA 92344-4691
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000017815 | CA | MD | Sports Medicine (Preventive Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1982093415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9327 AGAVE DR",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923444691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2280 DAMIEN AVE",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505210",
"telephone_number": "909-596-1946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "ALYSSA",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-21",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "2083S0010X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Sports Medicine",
"state": "CA",
"license": "2000017815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Verne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.