Active NPI
Camryn Debose
- Student in an Organized Health Care Education/Training Program
- Bridgeport, CT
National Provider Identifier
1013793009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 180 Fairfield Ave
Bridgeport, CT 06604-4252 - Phone
- (203) 394-6529
- NPI assigned
- Sep 5, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
180 Fairfield Ave
Bridgeport, CT 06604-4252
Mailing address
65 Abner St
West Haven, CT 06516-3306
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1013793009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 ABNER ST",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065163306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 FAIRFIELD AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066044252",
"telephone_number": "203-394-6529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOSE",
"first_name": "CAMRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-05",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.