Individual provider Active NPI

Sharon Donnelly, OT

  • Occupational Therapist
  • Bethel, CT
National Provider Identifier
1437636339
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
000563 Issued in CT
Practice address
13 Park Lawn Dr
Bethel, CT 06801-1043
Phone
(203) 830-4180
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 000563 CT Primary

Addresses

Primary practice location

13 Park Lawn Dr
Bethel, CT 06801-1043

Mailing address

465 Chestnut Tree Hill Rd
Southbury, CT 06488-1955
Phone (203) 232-0780

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

LicenseStateTypeSpecialty
000563CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Therapy Outpatient Services, LLC Multi-Specialty CurrentSince Sep 12, 2021 Accepting new patients

Locations

15 Park Lawn Dr
Bethel, CT 06801
Phone (203) 790-8520

3 Farm Rd
New Canaan, CT 06840
Phone (203) 594-5200

850 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 610-0400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1437636339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 CHESTNUT TREE HILL RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064881955",
            "telephone_number": "203-232-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PARK LAWN DR",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011043",
            "telephone_number": "203-830-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SHARON",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "000563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.