Active NPI
Keith Rupp, ATC
- Athletic Trainer
- Derry, NH
National Provider Identifier
1356486773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0255
- Practice address
- 85 Stonegate LN
Derry, NH 03038-2569 - Phone
- (603) 759-8588
- NPI assigned
- Feb 21, 2007
- 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 | 0255 | NH | Primary |
Addresses
Primary practice location
85 Stonegate LN
Derry, NH 03038-2569
Mailing address
420 S. Main St
Nashua, NH 03060-5086
Phone (603) 897-8616
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 |
|---|---|---|---|
| 0255 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356486773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 S. MAIN ST",
"city": "NASHUA",
"state": "NH",
"postal_code": "030605086",
"telephone_number": "603-897-8616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 STONEGATE LN",
"city": "DERRY",
"state": "NH",
"postal_code": "030382569",
"telephone_number": "603-759-8588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPP",
"first_name": "KEITH",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NH",
"license": "0255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derry, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.