Individual provider Active NPI

Jenna Marie McDuffee, OTR/L

  • Occupational Therapist
  • Ridgefield, CT
National Provider Identifier
1114431038
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12507 Issued in MA
Practice address
484 Ridgebury Rd
Ridgefield, CT 06877-1228
Phone
(203) 801-5254
NPI assigned
Nov 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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 12507 MA Primary

Addresses

Primary practice location

484 Ridgebury Rd
Ridgefield, CT 06877-1228

Mailing address

192 Leonard Rd
Stafford Springs, CT 06076-3303
Phone (860) 930-2920

Other practice location 1

120 Webster Square Rd
Berlin, CT 06037-2329
Phone (860) 420-3800

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
12507MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgebury Farm and Stables Occupational Therapist CurrentSince Nov 20, 2022 Accepting new patients

Locations

484 Ridgebury Rd
Ridgefield, CT 06877
Phone (203) 577-8684

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": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1114431038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 LEONARD RD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060763303",
            "telephone_number": "860-930-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 RIDGEBURY RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068771228",
            "telephone_number": "203-801-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Webster Square Rd",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "CT",
            "postal_code": "060372329",
            "country_code": "US",
            "telephone_number": "860-420-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDUFFEE",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.