Active NPI
Kristen Douglass, OT
- Occupational Therapist
- Nashua, NH
National Provider Identifier
1619036506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1187
- Practice address
- 144 Canal St
Nashua, NH 03064-2886 - Phone
- (603) 882-6333
- Fax
- (603) 459-2795
- NPI assigned
- Dec 6, 2006
- Last updated
- Aug 27, 2019
- 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 | 1187 | NH | Primary |
Addresses
Primary practice location
144 Canal St
Nashua, NH 03064-2886
Mailing address
144 Canal St
Nashua, NH 03064-2886
Phone (603) 459-2795
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99560056 | Medicaid | NH | |
| 020377315 | Other | NH | COMM TAX ID |
| 561822 | Other | NH | AETNA |
| 761242 | Other | NH | TUFTS |
| 13Y002968NH01 | Other | ANTHEM BCBS | |
| 272746 | Other | NH | CIGNA |
| 626514 | Other | NH | HARVARD PILGRIM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1187 | NH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1619036506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 CANAL ST",
"city": "NASHUA",
"state": "NH",
"postal_code": "030642886",
"telephone_number": "603-459-2795",
"fax_number": "603-459-2783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 CANAL ST",
"city": "NASHUA",
"state": "NH",
"postal_code": "030642886",
"telephone_number": "603-882-6333",
"fax_number": "603-459-2795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "KRISTEN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "1187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99560056",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMM TAX ID",
"identifier": "020377315",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "561822",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "761242",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "13Y002968NH01",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "272746",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "626514",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashua, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.