Individual provider Active NPI

Robert Douglas Frost, ATC, LAT

  • Athletic Trainer
  • West Haven, CT
National Provider Identifier
1063180651
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1251 Issued in CT
Practice address
13 Pauline Ave
West Haven, CT 06516-6928
Phone
(203) 745-6646
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X 1251 CT Primary

Addresses

Primary practice location

13 Pauline Ave
West Haven, CT 06516-6928

Mailing address

13 Pauline Ave
West Haven, CT 06516-6928
Phone (203) 745-6646

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1063180651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 PAULINE AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065166928",
            "telephone_number": "203-745-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PAULINE AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065166928",
            "telephone_number": "203-745-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "ROBERT",
        "middle_name": "DOUGLAS",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.