Active NPI
Heather Anne Talledo
- Occupational Therapist
- Weatogue, CT
National Provider Identifier
1366158396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002711
- Practice address
- 142 Cooper Ave
Weatogue, CT 06089-7957 - Phone
- (860) 317-0436
- NPI assigned
- Jan 24, 2023
- 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 Therapist | 225X00000X | 002711 | CT | Primary |
Addresses
Primary practice location
142 Cooper Ave
Weatogue, CT 06089-7957
Mailing address
25 Mountain View Dr
Weatogue, CT 06089-9721
Phone (860) 985-8885
Other names 1
- Heather Anne Kingsbury
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002711 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1366158396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 MOUNTAIN VIEW DR",
"city": "WEATOGUE",
"state": "CT",
"postal_code": "060899721",
"telephone_number": "860-985-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 COOPER AVE",
"city": "WEATOGUE",
"state": "CT",
"postal_code": "060897957",
"telephone_number": "860-317-0436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLEDO",
"first_name": "HEATHER",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-24",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "002711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "KINGSBURY",
"middle_name": "ANNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Weatogue, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.