Timothy Adam Kulpa, DAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT004005 Issued in PA

Practice address

133 N River St
Wilkes Barre, PA 18711-0800

Phone

(570) 208-5900

Fax

(570) 208-6016

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• King'S College

  • Student Health Clinic/Center
  • Wilkes Barre, PA
  • NPI 1164749966
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1003937376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110800",
            "telephone_number": "570-208-5900",
            "fax_number": "570-208-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110800",
            "telephone_number": "570-208-5900",
            "fax_number": "570-208-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULPA",
        "first_name": "TIMOTHY",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "DAT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaeger Kubikisha
• Nathan Zachary Kubus, PHARMD
• Kevin Ryan Kucharski, DO
• Deborah Ann Kuchenba, RO LDN
• Sagar Kulkarni, MD
• Puneet Kumar, MD
• Seema Kumari, MD
• Harshath Odeker Kundaranahalli Pradeep
• Samantha Lynn Kunkel, PHARMD
• Kyra Kuppler, PA-C

• Athletic Trainer in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.