Individual provider Active NPI

Colleen Britney Alane Redenback, COTA/L

  • Occupational Therapy Assistant
  • Fairlawn, OH
National Provider Identifier
1629919477
Registry record updated Apr 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713
Phone
(330) 867-2240
NPI assigned
Apr 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X Primary

Addresses

Primary practice location

150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713

Mailing address

3065 McIntosh Dr NE
Louisville, OH 44641-0089

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

NPI Registry JSON

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

{
    "created_epoch": "1775260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775260800000",
    "number": "1629919477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 MCINTOSH DR NE",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446410089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MILLER RD STE 150A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333713",
            "telephone_number": "330-867-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDENBACK",
        "first_name": "COLLEEN",
        "middle_name": "BRITNEY ALANE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-04",
        "last_updated": "2026-04-04",
        "certification_date": "2026-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2026; 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.