Active NPI
Brooke Sheila Venkitachalam
- Athletic Trainer
- Hamden, CT
National Provider Identifier
1154088383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 275 Mount Carmel Ave
Hamden, CT 06518-1908 - Phone
- (978) 760-9107
- NPI assigned
- Nov 22, 2021
- Last updated
- Nov 22, 2021
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | NU | Primary |
Addresses
Primary practice location
275 Mount Carmel Ave
Hamden, CT 06518-1908
Mailing address
478 W Townsend Rd
Lunenburg, MA 01462-1714
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": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1154088383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "478 W TOWNSEND RD",
"city": "LUNENBURG",
"state": "MA",
"postal_code": "014621714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MOUNT CARMEL AVE",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065181908",
"telephone_number": "978-760-9107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENKITACHALAM",
"first_name": "BROOKE",
"middle_name": "SHEILA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-22",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.