Kathryn Marie Malatestinic, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1500 Lexington Blvd
Bethel, CT 06801-1338

Phone

(203) 240-7122

NPI assigned

May 11, 2018

Last updated

Aug 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1881184109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 VILLAGE VIEW CIR APT 202",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280123199",
            "telephone_number": "203-240-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LEXINGTON BLVD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011338",
            "telephone_number": "203-240-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALATESTINIC",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NC",
            "license": "2000030923",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS",
            "identifier": "22",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Bethel, CT
• Providers in Bethel, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.