Active NPI
Kaitlyn Estrada
- Community Health Worker
- Waterbury, CT
National Provider Identifier
1871140210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 402 E Main St
Waterbury, CT 06702-1701 - Phone
- (203) 755-1143
- Fax
- (203) 753-3274
- NPI assigned
- Aug 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
402 E Main St
Waterbury, CT 06702-1701
Mailing address
141 E Main St
Waterbury, CT 06702-2310
Phone (203) 574-9000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1871140210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-574-9000",
"fax_number": "203-574-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021701",
"telephone_number": "203-755-1143",
"fax_number": "203-753-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "KAITLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.