Individual provider Active NPI

Kelly Yagud, OT

  • Occupational Therapist
  • Norwalk, CT
National Provider Identifier
1467515122
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
002609 Issued in CT
Practice address
1 Maher Dr
Norwalk, CT 06850-2416
Phone
(203) 258-7261
NPI assigned
Dec 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 0002609 CT
Occupational Therapist 225X00000X 002609 CT Primary

Addresses

Primary practice location

1 Maher Dr
Norwalk, CT 06850-2416

Mailing address

1 Maher Dr
Norwalk, CT 06850-2416
Phone (203) 258-7261

Other practice location 1

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

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

LicenseStateTypeSpecialty
002609CTMDOccupational Therapist
0002609CTMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467515122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAHER DR",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502416",
            "telephone_number": "203-258-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAHER DR",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502416",
            "telephone_number": "203-258-7261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1931 Black Rock Tpke",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068253506",
            "country_code": "US",
            "telephone_number": "203-384-8681",
            "fax_number": "203-384-0722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGUD",
        "first_name": "KELLY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CT",
            "license": "0002609",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "002609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.