Active NPI
Corrin L Campbell, COTA
- Occupational Therapy Assistant
- Southington, CT
National Provider Identifier
1194846519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 000797
- Practice address
- 45 Meriden Ave
Southington, CT 06489-3214 - Phone
- (860) 378-1234
- Fax
- (860) 378-1160
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- 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 Therapy Assistant | 224Z00000X | 000797 | CT | Primary |
Addresses
Primary practice location
45 Meriden Ave
Southington, CT 06489-3214
Mailing address
85 Edgewood Cir
Southington, CT 06489-2106
Phone (860) 621-0598
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 |
|---|---|---|---|
| 000797 | CT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194846519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 EDGEWOOD CIR",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064892106",
"telephone_number": "860-621-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 MERIDEN AVE",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064893214",
"telephone_number": "860-378-1234",
"fax_number": "860-378-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "CORRIN",
"middle_name": "L",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "000797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.