Active NPI
Kory Jayden Lazur, ATC
- Athletic Trainer
- Vernon, CT
National Provider Identifier
1316783715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000056296
- Practice address
- 70 Loveland Hill Rd
Vernon, CT 06066-6836 - Phone
- (860) 870-6314
- NPI assigned
- Jul 4, 2024
- Sex
- Male
- 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 | 2000056296 | CT | Primary |
Addresses
Primary practice location
70 Loveland Hill Rd
Vernon, CT 06066-6836
Mailing address
21 Johnston Ave
Willimantic, CT 06226-3207
Phone (860) 917-7950
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000056296 | CT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720051200000",
"number": "1316783715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 JOHNSTON AVE",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062263207",
"telephone_number": "860-917-7950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 LOVELAND HILL RD",
"city": "VERNON",
"state": "CT",
"postal_code": "060666836",
"telephone_number": "860-870-6314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZUR",
"first_name": "KORY",
"middle_name": "JAYDEN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-04",
"last_updated": "2024-07-04",
"certification_date": "2024-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "2000056296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.