Active NPI
Steven Fredrick Nackley, OTR/L
- Occupational Therapist
- Southington, CT
National Provider Identifier
1265103386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4495
- Practice address
- 45 Meriden Ave
Southington, CT 06489-3214 - Phone
- (860) 621-9559
- NPI assigned
- Sep 28, 2021
- Sex
- Male
- 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 | 4495 | CT | Primary |
Addresses
Primary practice location
45 Meriden Ave
Southington, CT 06489-3214
Mailing address
366 Park Rd Apt A1
West Hartford, CT 06119-1959
Phone (860) 798-5310
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 |
|---|---|---|---|
| 4495 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Senior Services, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Skilled Nursing Facility
- Southington, CT
- NPI 1265431647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632787200000",
"number": "1265103386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "366 PARK RD APT A1",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061191959",
"telephone_number": "860-798-5310"
},
{
"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": "860-621-9559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACKLEY",
"first_name": "STEVEN",
"middle_name": "FREDRICK",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-28",
"last_updated": "2021-09-28",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "4495",
"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 Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.