Active NPI
Nicole P. Connolly, OTR/L
- Occupational Therapist
- Portland, ME
National Provider Identifier
1245547876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT1497
- Practice address
- 196 Allen Ave
Portland, ME 04103-3711 - Phone
- (207) 874-8133
- NPI assigned
- Sep 2, 2010
- Sex
- Female
- Sole proprietor
- No
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 | OT1497 | ME | Primary |
Addresses
Primary practice location
196 Allen Ave
Portland, ME 04103-3711
Mailing address
33 Lyman St
Westbrook, ME 04092-3540
Phone (207) 318-4353
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 |
|---|---|---|---|
| OT1497 | ME | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1245547876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 LYMAN ST",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923540",
"telephone_number": "207-318-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 ALLEN AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041033711",
"telephone_number": "207-874-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "NICOLE",
"middle_name": "P.",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-02",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT1497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.