Stephanie Birch, ATC, EMT-B

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

000411 Issued in CT

Practice address

437 Pequot Ave
New London, CT 06320-4498

Phone

(860) 701-3518

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1679204267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 PEQUOT AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204498",
            "telephone_number": "860-701-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 PEQUOT AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204498",
            "telephone_number": "860-701-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCH",
        "first_name": "STEPHANIE",
        "credential": "ATC, EMT-B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CT",
            "license": "007199",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iris June Bernau, MSW LCSW ACSW BCD
• Gary M. Bertman, M.D.
• Kelsey Bestall
• Tiffany Galicia Beyer
• Alan L Bier, M.D.
• John Bitters, MA, LPC
• Shauna Rochelle Blake, FNP
• Mary L Blankson, APRN
• Beth Blazevich, APRN
• Margaret Louise Blevins, MSW

• Athletic Trainer in New London, CT
• Providers in New London, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.