Active NPI
Vanessa Cordero Gwara, OTR
- Occupational Therapist
- Windsor, CT
National Provider Identifier
1598436867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 005316
- Practice address
- 581 Poquonock Ave
Windsor, CT 06095-2202 - Phone
- (860) 688-7211
- NPI assigned
- Sep 25, 2021
- 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 | 005316 | CT | Primary |
Addresses
Primary practice location
581 Poquonock Ave
Windsor, CT 06095-2202
Mailing address
89 Ledgecrest Dr
Newington, CT 06111-4256
Phone (860) 212-5647
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 |
|---|---|---|---|
| 005316 | CT | MD | Clinical Social Worker |
| 5316 | CT | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1598436867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 LEDGECREST DR",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061114256",
"telephone_number": "860-212-5647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "581 POQUONOCK AVE",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952202",
"telephone_number": "860-688-7211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWARA",
"first_name": "VANESSA",
"middle_name": "CORDERO",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-25",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "005316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.