Individual provider Active NPI

Brian Wheeler, COTA/L

  • Occupational Therapy Assistant
  • Shelton, CT
National Provider Identifier
1598040024
Registry record updated Oct 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
001145 Issued in CT
Practice address
45 Maltby St
Shelton, CT 06484-3328
Phone
(203) 924-6174
NPI assigned
Oct 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2011

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 001145 CT Primary

Addresses

Primary practice location

45 Maltby St
Shelton, CT 06484-3328

Mailing address

75 Eagle View Rd
Southbury, CT 06488-4696
Phone (203) 706-0135

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
001145CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318723200000",
    "number": "1598040024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 EAGLE VIEW RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884696",
            "telephone_number": "203-706-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MALTBY ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843328",
            "telephone_number": "203-924-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "BRIAN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-16",
        "last_updated": "2011-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.