Active NPI
Douglas Michlovitz
- Athletic Trainer
- Sandy Hook, CT
National Provider Identifier
1497263248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000707
- Practice address
- 7 Canterbury LN
Sandy Hook, CT 06482-1576 - Phone
- (203) 364-9678
- NPI assigned
- Jan 15, 2018
- 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 | 000707 | CT | Primary |
Addresses
Primary practice location
7 Canterbury LN
Sandy Hook, CT 06482-1576
Mailing address
7 Canterbury LN
Sandy Hook, CT 06482-1576
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": "1515974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1497263248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CANTERBURY LN",
"city": "SANDY HOOK",
"state": "CT",
"postal_code": "064821576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 CANTERBURY LN",
"city": "SANDY HOOK",
"state": "CT",
"postal_code": "064821576",
"telephone_number": "203-364-9678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHLOVITZ",
"first_name": "DOUGLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-15",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy Hook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.