Ashley James

Individual provider Active NPI Athletic Trainer · Niantic, CT

NPI 1003372103 · NPPES record last updated Feb 13, 2019

Key facts

NPI
1003372103
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
001204 (CT)
Practice address
11 Industrial Park Rd
Niantic, CT 06357-0635
Phone
(860) 391-9397
NPI assigned
Feb 13, 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

State licenses

LicenseStateTypeSpecialty
001204CTMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 001204 CT Yes

Addresses

Primary practice location

11 Industrial Park Rd
Niantic, CT 06357-0635

Mailing address

51 Church St Apt 4
Mystic, CT 06355-2745
Phone (860) 391-9397

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 13, 2019.

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1003372103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CHURCH ST APT 4",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552745",
            "telephone_number": "860-391-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL PARK RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063570635",
            "telephone_number": "860-391-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "001204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niantic, CT

All providers in Niantic, CT · Athletic Trainer in Connecticut

Sources for this page

Verify at the official NPI Registry.