Active NPI
Julian Concannon
- Occupational Therapist
- Holyoke, MA
National Provider Identifier
1134597511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- AH 11028-OT
- Practice address
- 577 Pleasant St Apt 4R
Holyoke, MA 01040-2366 - Phone
- (781) 724-4546
- NPI assigned
- Sep 2, 2015
- Last updated
- Sep 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | AH 11028-OT | MA | Primary |
Addresses
Primary practice location
577 Pleasant St Apt 4R
Holyoke, MA 01040-2366
Mailing address
577 Pleasant St Apt 4R
Holyoke, MA 01040-2366
Phone (781) 724-4546
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
| License | State | Type | Specialty |
|---|---|---|---|
| AH 11028-OT | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1134597511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 PLEASANT ST APT 4R",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010402366",
"telephone_number": "781-724-4546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "577 PLEASANT ST APT 4R",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010402366",
"telephone_number": "781-724-4546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCANNON",
"first_name": "JULIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "AH 11028-OT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.