Active NPI
Lynda Jaeger, COTA
- Occupational Therapy Assistant
- Newington, CT
National Provider Identifier
1043322720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 000671
- Practice address
- 555 Willard Ave
Newington, CT 06111-2631 - Phone
- (860) 594-6369
- Fax
- (860) 667-6754
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 000671 | CT | Primary |
Addresses
Primary practice location
555 Willard Ave
Newington, CT 06111-2631
Mailing address
43 Stuart St
Newington, CT 06111-3742
Phone (860) 666-0652
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000671 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043322720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 STUART ST",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061113742",
"telephone_number": "860-666-0652",
"fax_number": "860-667-6754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 WILLARD AVE",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061112631",
"telephone_number": "860-594-6369",
"fax_number": "860-667-6754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAEGER",
"first_name": "LYNDA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "000671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.