Individual provider Active NPI

Kathleen Gormley, OTR/L, CHT

  • Occupational Therapist
  • Newtown, CT
National Provider Identifier
1487643987
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001906 Issued in CT
Practice address
33 Church Hill Rd
Newtown, CT 06470-1637
Phone
(475) 828-0932
Fax
(475) 209-8054
NPI assigned
Oct 18, 2005
Reactivated
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 001906 CT
Occupational Therapist 225X00000X 001906 CT Primary

Addresses

Primary practice location

33 Church Hill Rd
Newtown, CT 06470-1637

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (914) 294-4050

Other practice location 1

1320 W Main St
Building 2 The Hand Center of Waterbury
Waterbury, CT 06708-3119
Phone (203) 755-7115

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
001906CTMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1487643987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CHURCH HILL RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701637",
            "telephone_number": "475-828-0932",
            "fax_number": "475-209-8054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Main St",
            "address_2": "Building 2 The Hand Center of Waterbury",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067083119",
            "country_code": "US",
            "telephone_number": "203-755-7115",
            "fax_number": "203-755-7067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "KATHLEEN",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "deactivation_date": "2016-04-19",
        "reactivation_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CT",
            "license": "001906",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "001906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.