Individual provider Active NPI

Nathan Trucks, ST

  • Speech-Language Pathologist
  • Cheshire, CT
National Provider Identifier
1841842234
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5718 Issued in CT
Practice address
382 S Main St
Cheshire, CT 06410-3115
Phone
(203) 250-9663
Fax
(203) 699-9641
NPI assigned
Jul 15, 2019
Last updated
Jul 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5718 CT Primary

Addresses

Primary practice location

382 S Main St
Cheshire, CT 06410-3115

Mailing address

382 S Main St
Cheshire, CT 06410-3115
Phone (203) 250-9663

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
5718CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cheshire Fitness Zone, LLC Speech-Language Pathologist CurrentSince Jul 5, 2020 Accepting new patients

Locations

382 S Main St
Cheshire, CT 06410

1064 E Main St
Meriden, CT 06450
Phone (203) 235-9622

308 Racebrook Rd
Orange, CT 06477
Phone (203) 920-1881

157 Litchfield St
Torrington, CT 06790
Phone (860) 489-1328

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1841842234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103115",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103115",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUCKS",
        "first_name": "NATHAN",
        "credential": "ST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "5718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.