Active NPI
Stephanie Neidhart
- Athletic Trainer
- Sound Beach, NY
National Provider Identifier
1346899804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 111 Beacon Dr
Sound Beach, NY 11789-2016 - Phone
- (631) 601-3051
- NPI assigned
- Sep 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
111 Beacon Dr
Sound Beach, NY 11789-2016
Mailing address
111 Beacon Dr
Sound Beach, NY 11789-2016
Phone (631) 601-3051
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": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567900800000",
"number": "1346899804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 BEACON DR",
"city": "SOUND BEACH",
"state": "NY",
"postal_code": "117892016",
"telephone_number": "631-601-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BEACON DR",
"city": "SOUND BEACH",
"state": "NY",
"postal_code": "117892016",
"telephone_number": "631-601-3051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEIDHART",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sound Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.