Active NPI
Cathleen Marie Connolly, OT
- Occupational Therapist
- Sandpoint, ID
National Provider Identifier
1710149554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-863
- Practice address
- 220 S Division Ave
Sandpoint, ID 83864-1759 - Phone
- (208) 265-4514
- Fax
- (208) 263-3789
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | OT-863 | ID | Primary |
Addresses
Primary practice location
220 S Division Ave
Sandpoint, ID 83864-1759
Mailing address
220 S Division Ave
Sandpoint, ID 83864-1759
Phone (208) 265-4514
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 |
|---|---|---|---|
| OT-863 | ID | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1710149554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 S DIVISION AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641759",
"telephone_number": "208-265-4514",
"fax_number": "208-263-3789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 S DIVISION AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641759",
"telephone_number": "208-265-4514",
"fax_number": "208-263-3789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "CATHLEEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.