Individual provider Active NPI

Colleen Hermann, COTA-L

  • Occupational Therapy Assistant
  • Shelton, CT
National Provider Identifier
1003416835
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
001434 Issued in CT
Practice address
584 Long Hill Ave
Shelton, CT 06484-4810
Phone
(203) 944-8252
Fax
(203) 944-8297
NPI assigned
Oct 30, 2020
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 001434 CT Primary

Addresses

Primary practice location

584 Long Hill Ave
Shelton, CT 06484-4810

Mailing address

63 New St Apt 1
Naugatuck, CT 06770-2741
Phone (203) 521-1552

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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1003416835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 NEW ST APT 1",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702741",
            "telephone_number": "203-521-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 LONG HILL AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844810",
            "telephone_number": "203-944-8252",
            "fax_number": "203-944-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "COLLEEN",
        "credential": "COTA-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

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

Verify at the official NPI Registry.