Individual provider Active NPI

Kyle Alea, ATC, LAT

  • Athletic Trainer
  • Newark, DE
National Provider Identifier
1396377347
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
J3-0000742 Issued in DE
Practice address
1365 Pulaski Hwy
Newark, DE 19702-5105
Phone
(302) 356-4636
NPI assigned
Feb 7, 2020
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X J3-0000742 DE Primary

Addresses

Primary practice location

1365 Pulaski Hwy
Newark, DE 19702-5105

Mailing address

1365 Pulaski Hwy
Newark, DE 19702-5105

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

LicenseStateTypeSpecialty
J3-0000742DEMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1396377347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 PULASKI HWY",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 PULASKI HWY",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025105",
            "telephone_number": "302-356-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEA",
        "first_name": "KYLE",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.