Irene A Connell, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-1937 Issued in ID

Practice address

255 Magnolia Ave
Fruitland, ID 83619-5019

Phone

(541) 216-3142

NPI assigned

Jul 30, 2018

Last updated

Jul 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1689152928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MAGNOLIA AVE",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836195019",
            "telephone_number": "541-216-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MAGNOLIA AVE",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836195019",
            "telephone_number": "541-216-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "IRENE",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LICENSING BOARD",
            "identifier": "1020322",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE OCCUPATIONAL THERAPY LICENSURE BOARD",
            "identifier": "OT-1937",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY",
            "identifier": "1020322",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark David Christenson, MD
• Christian Counseling Services
• City of Fruitland (Payette County Paramedics)
• John Linton Close, RN
• Jesse Ray Cobb, LCSW
• CT Derm PC
• Bonnie Curren, HIS
• Current Physical Therapy LLC
• Cassie Dahle
• Jan Olof Dahlin, M.D.

• Occupational Therapist in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.