Active NPI
Keenan Thomas Love, ATC
- Athletic Trainer
- Cromwell, CT
National Provider Identifier
1881200962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000640
- Practice address
- 80 Shunpike Rd Unit 202
Cromwell, CT 06416-4402 - Phone
- (860) 632-1792
- Fax
- (860) 632-1802
- NPI assigned
- Sep 23, 2020
- 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 | 000640 | CT | Primary |
Addresses
Primary practice location
80 Shunpike Rd Unit 202
Cromwell, CT 06416-4402
Mailing address
7 Sagamore LN Unit 204
Rocky Hill, CT 06067-3842
Phone (860) 729-4174
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 |
|---|---|---|---|
| 000640 | CT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1881200962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 SAGAMORE LN UNIT 204",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060673842",
"telephone_number": "860-729-4174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SHUNPIKE RD UNIT 202",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064164402",
"telephone_number": "860-632-1792",
"fax_number": "860-632-1802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "KEENAN",
"middle_name": "THOMAS",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cromwell, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.