Individual provider Active NPI

Christina Konopka

  • Occupational Therapist
  • Stratford, CT
National Provider Identifier
1063957165
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004404 Issued in CT
Practice address
88 Ryders LN Ste 101
Stratford, CT 06614-1666
Phone
(203) 375-1101
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 004404 CT Primary

Addresses

Primary practice location

88 Ryders LN Ste 101
Stratford, CT 06614-1666

Mailing address

88 Ryders LN Ste 101
Stratford, CT 06614-1666
Phone (203) 375-1101

Other practice location 1

3030 Park Ave
Bridgeport, CT 06604-1138
Phone (203) 502-7593

Other names 1

  • Christina Gallo Former name

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
004404CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Wellness Solutions LLC CurrentSince Apr 9, 2024 Accepting new patients
CRK Wellness Solutions LLC CurrentSince Apr 9, 2024 Accepting new patients

Locations

88 Ryders Ln
Ste 101
Stratford, CT 06614
Phone (203) 375-1101

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1063957165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 RYDERS LN STE 101",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141666",
            "telephone_number": "203-375-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 RYDERS LN STE 101",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141666",
            "telephone_number": "203-375-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066041138",
            "country_code": "US",
            "telephone_number": "203-502-7593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONOPKA",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "004404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "GALLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.