Active NPI
Kyra Busque, LAT ATC
- Athletic Trainer
- South Hadley, MA
National Provider Identifier
1780120550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2934
- Practice address
- 50 College St
Kendall Dance and Sports Complex Room 126a
South Hadley, MA 01075-1423 - Phone
- (413) 538-3316
- NPI assigned
- Jan 17, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2934 | MA | Primary |
Addresses
Primary practice location
50 College St
Kendall Dance and Sports Complex Room 126a
South Hadley, MA 01075-1423
Mailing address
4 Dobson Rd
Vernon, CT 06066-5430
Phone (860) 888-2789
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 |
|---|---|---|---|
| 2934 | MA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1780120550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 DOBSON RD",
"city": "VERNON",
"state": "CT",
"postal_code": "060665430",
"telephone_number": "860-888-2789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 COLLEGE ST",
"address_2": "KENDALL DANCE AND SPORTS COMPLEX ROOM 126A",
"city": "SOUTH HADLEY",
"state": "MA",
"postal_code": "010751423",
"telephone_number": "413-538-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSQUE",
"first_name": "KYRA",
"name_prefix": "Miss",
"credential": "LAT ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-17",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "2934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hadley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.