Active NPI
Jennifer Decoteau
- Occupational Therapist
- Avon, CT
National Provider Identifier
1588065601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 003907
- Practice address
- 101 Bickford Ext
Avon, CT 06001 - Phone
- (860) 269-5078
- NPI assigned
- Sep 8, 2014
- 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 | 003907 | CT | Primary |
Addresses
Primary practice location
101 Bickford Ext
Avon, CT 06001
Mailing address
31 Crystal Dr
East Granby, CT 06026-8705
Phone (203) 520-4418
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003907 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1588065601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 CRYSTAL DR",
"city": "EAST GRANBY",
"state": "CT",
"postal_code": "060268705",
"telephone_number": "203-520-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BICKFORD EXT",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-269-5078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECOTEAU",
"first_name": "JENNIFER",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-08",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "003907",
"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 Aug 29, 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.