Keshap Gautam

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

001413 Issued in CT

Practice address

45 Meriden Ave
Southington, CT 06489-3214

Phone

(860) 453-4170

NPI assigned

Apr 16, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1356760433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MERIDEN AVE",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893214",
            "telephone_number": "949-371-4733"
        },
        {
            "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": "860-453-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "KESHAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001413",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "2638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seva Galanis, LCSW, LADC
• Taylor O Gallimore, LCSW
• Gwynetta Gallup
• Tanya Antoinette Galvin, RPH
• David Gardner, PHARMD
• Brendan Gauthier, DC
• Jillian Theresa Gawricki, MT-BC
• General Medical Practice Associates, P.C.
• Vickie Christine Gerdon, PA-C
• Kristin D Gilbert, OTR/L

• Occupational Therapy Assistant in Southington, CT
• Providers in Southington, CT by specialty
• Occupational Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.