Individual provider Active NPI

Colleen Elizabeth O'Connell, OTR/L

  • Occupational Therapist
  • Lyndeborough, NH
National Provider Identifier
1619317526
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2316 Issued in NH
Practice address
1124 Center Rd
Lyndeborough, NH 03082-6105
Phone
(603) 769-1852
NPI assigned
Jun 25, 2013
Last updated
Jun 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2316 NH Primary
Occupational Therapist 225X00000X 10810 MA
Occupational Therapist 225X00000X 12093 CA

Addresses

Primary practice location

1124 Center Rd
Lyndeborough, NH 03082-6105

Mailing address

1124 Center Rd
Lyndeborough, NH 03082-6105
Phone (603) 769-1852

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

LicenseStateTypeSpecialty
2316NHMDAddiction (Substance Use Disorder) Counselor
12093CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Occupational Therapist Past Accepting new patients
Great Bay in-Home Therapy PastSince May 20, 2013 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1619317526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 CENTER RD",
            "city": "LYNDEBOROUGH",
            "state": "NH",
            "postal_code": "030826105",
            "telephone_number": "603-769-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 CENTER RD",
            "city": "LYNDEBOROUGH",
            "state": "NH",
            "postal_code": "030826105",
            "telephone_number": "603-769-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "2316",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "10810",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndeborough, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.