Active NPI
Kaitlyn Nicole Palevo, MS, ATC, LAT
- Athletic Trainer
- Fairfield, CT
National Provider Identifier
1952827255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000584
- Practice address
- 5151 Park Ave
Fairfield, CT 06825-1090 - Phone
- (203) 365-7672
- Fax
- (203) 365-4704
- NPI assigned
- Aug 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 000584 | CT | Primary |
Addresses
Primary practice location
5151 Park Ave
Fairfield, CT 06825-1090
Mailing address
28 McNeil Ter
Stratford, CT 06614-3946
Phone (617) 285-1655
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000584 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609286400000",
"number": "1952827255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 MCNEIL TER",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066143946",
"telephone_number": "617-285-1655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 PARK AVE",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251090",
"telephone_number": "203-365-7672",
"fax_number": "203-365-4704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALEVO",
"first_name": "KAITLYN",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "MS, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2020-12-30",
"certification_date": "2020-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.