Mirka Normand, OTR, MA, CHT, COMT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4617-026 Issued in WI

Practice address

52 Hazelnut Hill Rd
Groton, CT 06340-3268

Phone

(860) 446-8265

Fax

(860) 445-2076

NPI assigned

Feb 2, 2007

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1023156759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 HAZELNUT HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403268",
            "telephone_number": "860-446-8265",
            "fax_number": "860-445-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 HAZELNUT HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403268",
            "telephone_number": "860-446-8265",
            "fax_number": "860-445-2076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6408 Copps Ave",
            "address_purpose": "LOCATION",
            "city": "Monona",
            "state": "WI",
            "postal_code": "537163702",
            "country_code": "US",
            "telephone_number": "608-417-3131",
            "fax_number": "608-417-3130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORMAND",
        "first_name": "MIRKA",
        "name_prefix": "Mrs.",
        "credential": "OTR, MA, CHT, COMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WI",
            "license": "4617-026",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "TX",
            "license": "109297",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4617-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41064900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Groton, CT
• Providers in Groton, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.