Individual provider Active NPI

Lindsay Trudell Robillard

  • Athletic Trainer
  • New Haven, CT
National Provider Identifier
1629291042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000314 Issued in CT
Practice address
20 Tower Pkwy
New Haven, CT 06511-8930
Phone
(203) 464-8848
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 000314 CT Primary

Addresses

Primary practice location

20 Tower Pkwy
New Haven, CT 06511-8930

Mailing address

99 Lawncrest Rd
New Haven, CT 06515-1508
Phone (203) 464-8848

Other identifiers 1

IdentifierTypeStateIssuer
000314OtherCTATHLETIC TRAINING

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
000314CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629291042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 LAWNCREST RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151508",
            "telephone_number": "203-464-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 TOWER PKWY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065118930",
            "telephone_number": "203-464-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBILLARD",
        "first_name": "LINDSAY",
        "middle_name": "TRUDELL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING",
            "identifier": "000314",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

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.

Verify at the official NPI Registry.