Individual provider Active NPI

Anne Perri Koba, OTR/L

  • Pediatric Occupational Therapist
  • Branford, CT
National Provider Identifier
1023871670
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
001072 Issued in CT
Practice address
1294 Main St #815
Branford, CT 06405
Phone
(203) 518-8447
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 001072 CT Primary

Addresses

Primary practice location

1294 Main St #815
Branford, CT 06405

Mailing address

97 Harvest Woods Rd
Rockfall, CT 06481-2052
Phone (860) 995-0532

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1023871670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 HARVEST WOODS RD",
            "city": "ROCKFALL",
            "state": "CT",
            "postal_code": "064812052",
            "telephone_number": "860-995-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 MAIN ST #815",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-518-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBA",
        "first_name": "ANNE",
        "middle_name": "PERRI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CT",
            "license": "001072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.