Active NPI
Nicole Klarides-Ditria, ATC.L.
- Athletic Trainer
- Milford, CT
National Provider Identifier
1922534320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000284
- Practice address
- 200 High St
Milford, CT 06460-3249 - Phone
- (203) 410-8322
- NPI assigned
- May 4, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000284 | CT | Primary |
Addresses
Primary practice location
200 High St
Milford, CT 06460-3249
Mailing address
23 Osprey Dr
Seymour, CT 06483-2368
Phone (203) 410-8322
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 |
|---|---|---|---|
| 000284 | CT | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1922534320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 OSPREY DR",
"city": "SEYMOUR",
"state": "CT",
"postal_code": "064832368",
"telephone_number": "203-410-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HIGH ST",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603249",
"telephone_number": "203-410-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLARIDES-DITRIA",
"first_name": "NICOLE",
"credential": "ATC.L.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-04",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.