Individual provider Active NPI

Juliet Olala

  • Occupational Therapist
  • Ridgefield, CT
National Provider Identifier
1124515051
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6484 Issued in CT
Practice address
27 Governor St
Ridgefield, CT 06877-4608
Phone
(864) 906-0877
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 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 6484 CT Primary

Addresses

Primary practice location

27 Governor St
Ridgefield, CT 06877-4608

Mailing address

27 Governor St
Ridgefield, CT 06877-4608
Phone (864) 906-0877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114001782 CT Practitioner - Occupational Therapist in Private Practice 5597299446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab by Rvna LLCGroup PAC ID 2466747019, 25 clinicians

Practice addresses (Care Compare)

27 Governor St
Ridgefield, CT 06877-4608
Phone (203) 438-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6484CTMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab by Rvna, LLC CurrentSince Oct 15, 2024 Accepting new patients

Locations

27 Governor St
Ridgefield, CT 06877
Phone (203) 438-5555

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, 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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1124515051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 GOVERNOR ST",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774608",
            "telephone_number": "864-906-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GOVERNOR ST",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774608",
            "telephone_number": "864-906-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLALA",
        "first_name": "JULIET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "6484",
            "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 Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.