Individual provider Active NPI

Christy Marie Dutko, MS, OTR/L

  • Occupational Therapist
  • Southbury, CT
National Provider Identifier
1043597388
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003866 Issued in CT
Practice address
1 Reservoir Office Park Ste 104
1449 Old Waterbury Road
Southbury, CT 06488-3926
Phone
(203) 262-9909
Fax
(203) 262-9911
NPI assigned
Nov 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 003866 CT Primary

Addresses

Primary practice location

1 Reservoir Office Park Ste 104
1449 Old Waterbury Road
Southbury, CT 06488-3926

Mailing address

176 Warwick Rd
Watertown, CT 06795-1850
Phone (203) 910-7940

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
003866CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Kinections, LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1043597388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 WARWICK RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951850",
            "telephone_number": "203-910-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RESERVOIR OFFICE PARK STE 104",
            "address_2": "1449 OLD WATERBURY ROAD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883926",
            "telephone_number": "203-262-9909",
            "fax_number": "203-262-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTKO",
        "first_name": "CHRISTY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "003866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.