Connie Phung, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT013878 Issued in OH

Practice address

30630 Ridge Rd
Wickliffe, OH 44092-1166

Phone

(440) 943-2050

NPI assigned

Sep 3, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1417866641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 ANSEL RD # 408",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064106",
            "telephone_number": "440-454-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30630 RIDGE RD",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921166",
            "telephone_number": "440-943-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "OH",
            "postal_code": "441434422",
            "country_code": "US",
            "telephone_number": "216-289-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "CONNIE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT013878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Wickliffe, OH
• Providers in Wickliffe, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.