Active NPI
Kenneth Peisecki, OT
- Occupational Therapist
- Wilton, CT
National Provider Identifier
1427379791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC011370
- Practice address
- 64 Danbury Rd
Wilton, CT 06897-4429 - Phone
- (203) 800-0332
- Fax
- (800) 970-5001
- NPI assigned
- Jun 21, 2010
- Sex
- Male
- 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 | OC011370 | PA | Primary |
Addresses
Primary practice location
64 Danbury Rd
Wilton, CT 06897-4429
Mailing address
6802 Chateau Chase Dr
Columbus, OH 43235-3940
Phone (614) 352-4680
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 |
|---|---|---|---|
| OC011370 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1427379791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6802 CHATEAU CHASE DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432353940",
"telephone_number": "614-352-4680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 DANBURY RD",
"city": "WILTON",
"state": "CT",
"postal_code": "068974429",
"telephone_number": "203-800-0332",
"fax_number": "800-970-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEISECKI",
"first_name": "KENNETH",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-21",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC011370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.