Active NPI
Adam Michael Koropatkin
- Behavior Analyst
- Colchester, CT
National Provider Identifier
1629782446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA.001417
- Practice address
- 106 Westchester Rd
Colchester, CT 06415-2420 - Phone
- (860) 365-1011
- NPI assigned
- Jan 6, 2023
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BA.001417 | CT | Primary |
Addresses
Primary practice location
106 Westchester Rd
Colchester, CT 06415-2420
Mailing address
113 Salem Tpke Ste 200
Norwich, CT 06360-6484
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
| License | State | Type | Specialty |
|---|---|---|---|
| BA.001417 | CT | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1629782446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 SALEM TPKE STE 200",
"city": "NORWICH",
"state": "CT",
"postal_code": "063606484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 WESTCHESTER RD",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064152420",
"telephone_number": "860-365-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOROPATKIN",
"first_name": "ADAM",
"middle_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-06",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CT",
"license": "BA.001417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.