Active NPI
David J. Anderson, ATC
- Athletic Trainer
- New Britain, CT
National Provider Identifier
1831225630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000062
- Practice address
- 35 Lakeview Ave
New Britain, CT 06052-1921 - Phone
- (860) 225-5419
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 000062 | CT | Primary |
Addresses
Primary practice location
35 Lakeview Ave
New Britain, CT 06052-1921
Mailing address
35 Lakeview Ave
New Britain, CT 06052-1921
Phone (860) 225-5419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | CT | ATHLETIC TRAINER |
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 |
|---|---|---|---|
| 000062 | CT | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831225630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 LAKEVIEW AVE",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060521921",
"telephone_number": "860-225-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 LAKEVIEW AVE",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060521921",
"telephone_number": "860-225-5419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DAVID",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000062",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "22",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.