Active NPI
Sharon Nicoll, OTA
- Occupational Therapy Assistant
- Bristol, CT
National Provider Identifier
1285893263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 000922
- Practice address
- 10 N Main Street
Bristol, CT 06010 - Phone
- (860) 584-1485
- Fax
- (860) 585-5445
- NPI assigned
- Jun 5, 2008
- 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 Therapy Assistant | 224Z00000X | 000922 | CT | Primary |
Addresses
Primary practice location
10 N Main Street
Bristol, CT 06010
Mailing address
181 Patricia M Genova Drive
Eastern Rehabilitation Network
Newington, CT 06111
Phone (860) 667-5480
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 |
|---|---|---|---|
| 000922 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212624000000",
"number": "1285893263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 PATRICIA M GENOVA DRIVE",
"address_2": "EASTERN REHABILITATION NETWORK",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "06111",
"telephone_number": "860-667-5480",
"fax_number": "860-667-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N MAIN STREET",
"city": "BRISTOL",
"state": "CT",
"postal_code": "06010",
"telephone_number": "860-584-1485",
"fax_number": "860-585-5445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLL",
"first_name": "SHARON",
"credential": "OTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-05",
"last_updated": "2008-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "000922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.