Katelyn Dezenzo, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2763 Issued in MA

Practice address

Bates College
130 Central Avenue
Lewiston, ME 04240

Phone

(207) 786-6470

Fax

(207) 755-5839

NPI assigned

Dec 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katelyn Kinney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1588095947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N HARVARD ST",
            "address_2": "DILLON FIELD HOUSE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021631010",
            "telephone_number": "617-495-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BATES COLLEGE",
            "address_2": "130 CENTRAL AVENUE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-786-6470",
            "fax_number": "207-755-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZENZO",
        "first_name": "KATELYN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "KINNEY",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia A. Desoi, M.D.
• David A Dettmann, DO
• Meghan B Devin
• Louise Yvette Devlin, LMT
• Ruth A. Dewitt, LCPC, LADC
• Veronica L Diamond, PMHNP
• John D Dickens Jr., MD, MPH, SFHM
• Danielle Dill
• Dominique Dionne, COTA/L
• Luc Jasmine Dionne, D.C.

• Athletic Trainer in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.