MR. ALFRED RANDALL GONZALES (NPI# 1801294673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801294673 |
| Entity Type | Individual |
| Full Name | MR. ALFRED RANDALL GONZALES |
| Credential | ATC |
| Practice Address |
15755 Jefferson Hwy Baton Rouge LA 70817-6313 |
| Practice Telephone | 2257531200 |
| Practice Fax Number | 2257519269 |
| Mailing Telephone | 2257531200 |
| Mailing Fax Number | 2257519269 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
ATHJ00072 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063786127 | Alfred Gonzales | Licensed Practical Nurse | 1733 Vine St, Denver, CO 80206-1119 | 2012-03-06 |
| Street Address |
15755 JEFFERSON HWY |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70817-6313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
| 1457821043 | Traci Bellazin | Case Manager/Care Coordinator | 9334 Falling Oak Dr., Baton Rouge, LA 70817 | 2018-11-27 |
| 1124502869 | Jacob Schrieffer | Nurse Practitioner | 15389 Airline Highway, Baton Rouge, LA 70817 | 2018-09-19 |
| 1629564638 | Baton Rouge Dental Associates, LLC | Dentist | 14948 Market St, Baton Rouge, LA 70817 | 2018-07-03 |
| 1740786946 | Charlotte L Watts | Nurse Practitioner | 15389 Airline Hwy, Baton Rouge, LA 70817 | 2018-04-05 |
| 1164957536 | Deranecha Francois | Counselor | 17232 Jefferson Hwy, Apt 121, Baton Rouge, LA 70817 | 2017-04-24 |
| 1992251573 | Jacob Dent, Dds. Baton Rouge Modern Dentistry, A Professional Corp | Dentist | 14640 Village Market St, Suite 103, Baton Rouge, LA 70817 | 2016-09-01 |
| 1235522962 | Cardinal Community Services LLC | Clinic/Center | 13702 Coursey Blvd. Bldg 6 Ste A 2, Baton Rouge, LA 70817 | 2015-03-05 |
| 1962832204 | Bcbr Facility Services, LLC | Clinic/Center | 277 Rue De La Vie, Baton Rouge, LA 70817 | 2013-11-23 |
| 1700225737 | Renee Denise Beyer Boudreaux | Nurse Practitioner | 500 Rue De La Vie, Suite 401, Baton Rouge, LA 70817 | 2013-06-24 |
| Find all providers in zip 70817 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848116 | Kerry Michael Ruiz | Specialist/Technologist | 2378 Kensington Dr, Baton Rouge, LA 70809-1210 | 2020-10-14 |
| 1770199531 | Ryan Petrossi | Specialist/Technologist | 11959 Nicholson Dr Apt 17304, Baton Rouge, LA 70810-7626 | 2020-09-17 |
| 1265068241 | Bryan C Hutson | Specialist/Technologist | 10200 E Brookside Dr, Baton Rouge, LA 70818-5499 | 2020-03-21 |
| 1013552512 | Kelly Stephens | Specialist/Technologist | 1 North Stadium Dr, Baton Rouge, LA 70803-0001 | 2019-11-08 |
| 1326681115 | Carlie Mays | Specialist/Technologist | 339 Florida St, Baton Rouge, LA 70801-1721 | 2019-10-24 |
| 1649822164 | Joshua Vaughn Bunch | Specialist/Technologist | Lsu Athletic Department, Athletic Training, North Stadium Drive, Baton Rouge, LA 70803 | 2019-07-15 |
| 1740832906 | Meghan Reid Jackson | Specialist/Technologist | 777 Summer Breeze Dr, Baton Rouge, LA 70810-6187 | 2019-07-09 |
| 1801455928 | Cory Couture | Specialist/Technologist | 15535 Babblingbrook Dr, Baton Rouge, LA 70816-3295 | 2019-06-12 |
| 1821554635 | Jolie Tang | Specialist/Technologist | 1 Swan St, Baton Rouge, LA 70813-2260 | 2019-02-17 |
| 1003371527 | Reagan Claire Skidmore | Specialist/Technologist | 17017 Culps Bluff Ave, Baton Rouge, LA 70817-3339 | 2019-02-08 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70817 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.