Individual provider Active NPI

Kerri Vitolo, BCBA

  • Behavior Analyst
  • New Fairfield, CT
National Provider Identifier
1689086068
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-15122
Practice address
53 Rocky Hill Rd
New Fairfield, CT 06812-2726
Phone
(203) 733-1190
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-15122 Primary
Specialist 174400000X 1156201 NY

Addresses

Primary practice location

53 Rocky Hill Rd
New Fairfield, CT 06812-2726

Mailing address

53 Rocky Hill Rd
New Fairfield, CT 06812-2726
Phone (203) 733-1190

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
1156201NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1689086068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 ROCKY HILL RD",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068122726",
            "telephone_number": "203-733-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 ROCKY HILL RD",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068122726",
            "telephone_number": "203-733-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITOLO",
        "first_name": "KERRI",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-14-15122",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1156201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.