NPIMap

Organization Active NPI

Livewell Alliance, Inc.

  • Occupational Therapist
  • Plantsville, CT
National Provider Identifier
1396271532
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003405 Issued in CT
Legal business name
LIVEWELL ALLIANCE, INC.
Practice address
1261 S Main St
Plantsville, CT 06479-1750
Phone
(860) 628-9000
NPI assigned
May 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Anya Marisse Bounds
Title
Dir of Rev & Reimbursement
Phone
(860) 628-3059

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 009647 CT
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 003405 CT Primary

Addresses

Primary practice location

1261 S Main St
Plantsville, CT 06479-1750

Mailing address

1261 S Main St
Plantsville, CT 06479-1750
Phone (860) 628-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170911000483 CT Part B Supplier - Clinic/Group Practice 1052449162 Receives reassigned benefits from 5 practitioners
Practice locations: Plantsville, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1396271532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791750",
            "telephone_number": "860-628-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791750",
            "telephone_number": "860-628-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL ALLIANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BOUNDS",
        "authorized_official_first_name": "ANYA",
        "authorized_official_middle_name": "MARISSE",
        "authorized_official_title_or_position": "DIR OF REV & REIMBURSEMENT",
        "authorized_official_telephone_number": "860-628-3059"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009647",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "003405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantsville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.