Individual provider Active NPI

Mary Catherine Sheehan, OTR

  • Occupational Therapist
  • Waterbury, CT
National Provider Identifier
1740421619
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001338 Issued in CT
Practice address
22 Tompkins St
Waterbury, CT 06708-1459
Phone
(203) 419-0381
Fax
(203) 419-0389
NPI assigned
Mar 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 001338 CT Primary

Addresses

Primary practice location

22 Tompkins St
Waterbury, CT 06708-1459

Mailing address

88 Bear Run
Woodbury, CT 06798-3334
Phone (203) 263-4144

Other identifiers 1

IdentifierTypeStateIssuer
004190328MedicaidCT

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

LicenseStateTypeSpecialty
001338CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1740421619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 BEAR RUN",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983334",
            "telephone_number": "203-263-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TOMPKINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081459",
            "telephone_number": "203-419-0381",
            "fax_number": "203-419-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "001338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004190328",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.