Tristen Dyer, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1576 Issued in CT

Practice address

411 Wolcott Hill Rd
Wethersfield, CT 06109-2981

Phone

(207) 265-6506

NPI assigned

Oct 20, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1497537724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BARWOOD MNR",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WOLCOTT HILL RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061092981",
            "telephone_number": "207-265-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "TRISTEN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "1576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A. Drezek, P.A-C
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• Francesca M Durant, PT
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• Eastern Rehabiltation Network
• Jefferson Ebube, MD
• Kristin Elek, APRN
• Ahmed Elwan, MD, RPVI
• David Keith Emmel, M.D.

• Athletic Trainer in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.