Active NPI
Kurt Johnson
- Athletic Trainer
- Wallingford, CT
National Provider Identifier
1982110144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 10 Pond CT
Wallingford, CT 06492-2142 - Phone
- (203) 605-7258
- NPI assigned
- Dec 22, 2017
- 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 | Primary |
Addresses
Primary practice location
10 Pond CT
Wallingford, CT 06492-2142
Mailing address
10 Pond CT
Wallingford, CT 06492-2142
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": "1513900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1982110144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 POND CT",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064922142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 POND CT",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064922142",
"telephone_number": "203-605-7258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KURT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-22",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.