Individual provider Active NPI

Patricia M Henni, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Wakefield, MA
National Provider Identifier
1063235000
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OTL3340 Issued in MA
Practice address
607 North Ave
Door#18, 2ND Floor
Wakefield, MA 01880-1301
Phone
(617) 797-6702
NPI assigned
Nov 7, 2024
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OTL3340 MA Primary

Addresses

Primary practice location

607 North Ave
Door#18, 2ND Floor
Wakefield, MA 01880-1301

Mailing address

607 North Ave
Door#18, 2ND Floor
Wakefield, MA 01880
Phone (617) 797-6702

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

LicenseStateTypeSpecialty
OTL3340MAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1063235000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 NORTH AVE",
            "address_2": "DOOR#18, 2ND FLOOR",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "01880",
            "telephone_number": "617-797-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 NORTH AVE",
            "address_2": "DOOR#18, 2ND FLOOR",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801301",
            "telephone_number": "617-797-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNI",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MA",
            "license": "OTL3340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.