Individual provider Active NPI

Timothy Gugino, COTA

  • Occupational Therapy Assistant
  • Southbury, CT
National Provider Identifier
1538512652
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
001203 Issued in CT
Practice address
493 Heritage Rd
Suite1C
Southbury, CT 06488-3879
Phone
(631) 278-0665
Fax
(631) 619-6680
NPI assigned
Jul 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 001203 CT Primary

Addresses

Primary practice location

493 Heritage Rd
Suite1C
Southbury, CT 06488-3879

Mailing address

10 Wendover Rd
Newtown, CT 06470-1323
Phone (203) 241-4074

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
001203CTMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1538512652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WENDOVER RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701323",
            "telephone_number": "203-241-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 HERITAGE RD",
            "address_2": "SUITE1C",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883879",
            "telephone_number": "631-278-0665",
            "fax_number": "631-619-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGINO",
        "first_name": "TIMOTHY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.