Individual provider Active NPI

Amanda Lizotte

  • Student in an Organized Health Care Education/Training Program
  • Enfield, CT
National Provider Identifier
1275067878
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
153 Hazard Ave
Enfield, CT 06082
Phone
(860) 731-5522
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

153 Hazard Ave
Enfield, CT 06082

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 731-5522

Other practice location 1

444 Center St
Manchester, CT 06040-3926
Phone (860) 646-3888

Other practice location 2

444 Center St
Manchester, CT 06040-3926
Phone (860) 646-3888

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1275067878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "06082",
            "telephone_number": "860-731-5522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Center St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060403926",
            "country_code": "US",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Center St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060403926",
            "country_code": "US",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIZOTTE",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2019-08-13",
        "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 Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.