Jana Faith Alfred

Key facts

NPI

1992367668

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

Practice address

615 McCallie Ave
Chattanooga, TN 37403-2504

Phone

(423) 425-4111

NPI assigned

Jul 2, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 2, 2019.

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1992367668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 TOUCAN LN",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928790814",
            "telephone_number": "951-833-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032504",
            "telephone_number": "423-425-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFRED",
        "first_name": "JANA",
        "middle_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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