Active NPI
Nancy C Jackson, OT
- Occupational Therapist
- Avon, CT
National Provider Identifier
1558666453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 003024
- Practice address
- 21 Waterville Rd
Allstar
Avon, CT 06001-2097 - Phone
- (860) 678-9755
- NPI assigned
- Jan 24, 2011
- Last updated
- Jan 24, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 003024 | CT | Primary |
Addresses
Primary practice location
21 Waterville Rd
Allstar
Avon, CT 06001-2097
Mailing address
21 Waterville Rd
Allstar
Avon, CT 06001-2097
Phone (860) 678-9755
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1558666453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"address_2": "ALLSTAR",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-678-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"address_2": "ALLSTAR",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-678-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "NANCY",
"middle_name": "C",
"name_prefix": "Miss",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "003024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.