Active NPI
Nicholas Leimbach, ATC
- Athletic Trainer
- Lakeville, CT
National Provider Identifier
1073154803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 998
- Practice address
- 11 Interlaken Rd
Lakeville, CT 06039-2141 - Phone
- (401) 569-5102
- NPI assigned
- Oct 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 998 | CT | Primary |
Addresses
Primary practice location
11 Interlaken Rd
Lakeville, CT 06039-2141
Mailing address
PO Box 602
Lakeville, CT 06039-0602
Phone (401) 569-5102
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": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1073154803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602",
"city": "LAKEVILLE",
"state": "CT",
"postal_code": "060390602",
"telephone_number": "401-569-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 INTERLAKEN RD",
"city": "LAKEVILLE",
"state": "CT",
"postal_code": "060392141",
"telephone_number": "401-569-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIMBACH",
"first_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.