Individual provider Active NPI

Daniel Jonathan Schultheis

  • Athletic Trainer
  • Hamden, CT
National Provider Identifier
1801494570
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
00461901 Issued in NY
Practice address
275 Mount Carmel Ave
Hamden, CT 06518-1961
Phone
(203) 582-8200
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X 00461901 NY Primary

Addresses

Primary practice location

275 Mount Carmel Ave
Hamden, CT 06518-1961

Mailing address

32 Hampton CT
Woodbury, NY 11797-2425

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
00461901NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1801494570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HAMPTON CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181961",
            "telephone_number": "203-582-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTHEIS",
        "first_name": "DANIEL",
        "middle_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "00461901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.