Active NPI
Heather Dupree Vines-Dubose, OTRL
- Neurorehabilitation Occupational Therapist
- Norwalk, CT
National Provider Identifier
1497875645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- License
- 002169
- Practice address
- 698 West Ave
Norwalk, CT 06850-3302 - Phone
- (203) 852-3400
- Fax
- (203) 852-3418
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | 002169 | CT | Primary |
Addresses
Primary practice location
698 West Ave
Norwalk, CT 06850-3302
Mailing address
543 Lakeside Dr
Bridgeport, CT 06606-1949
Phone (203) 979-0010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130321000103 | CT | Practitioner - Occupational Therapist in Private Practice | 6901041052 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002169 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1497875645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "543 LAKESIDE DR",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061949",
"telephone_number": "203-979-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "698 WEST AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503302",
"telephone_number": "203-852-3400",
"fax_number": "203-852-3418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINES-DUBOSE",
"first_name": "HEATHER",
"middle_name": "DUPREE",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "CT",
"license": "002169",
"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 Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.