Individual provider Active NPI

Kimberly Hajjar, OTR

  • Pediatric Occupational Therapist
  • Wallingford, CT
National Provider Identifier
1124163605
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
001344 Issued in CT
Practice address
101 N Plains Industrial Rd
Building 2
Wallingford, CT 06492-2360
Phone
(203) 949-9337
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 001344 CT Primary

Addresses

Primary practice location

101 N Plains Industrial Rd
Building 2
Wallingford, CT 06492-2360

Mailing address

1300 Post Rd Ste 204
Fairfield, CT 06824-6038
Phone (203) 255-3669

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
001344CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pediatric Therapy-Fairfield, Inc. Pediatrics Past Accepting new patients
Center for Pediatric Therapy-Fairfield, Inc. Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1124163605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 POST RD STE 204",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246038",
            "telephone_number": "203-255-3669",
            "fax_number": "203-255-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N PLAINS INDUSTRIAL RD",
            "address_2": "BUILDING 2",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922360",
            "telephone_number": "203-949-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJJAR",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CT",
            "license": "001344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.