Individual provider Active NPI

Erin Russo

  • Pediatric Occupational Therapist
  • Hebron, CT
National Provider Identifier
1780353987
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
6246 Issued in CT
Practice address
33 Pendleton Dr
Hebron, CT 06248-1512
Phone
(860) 207-3665
Fax
(860) 812-2151
NPI assigned
Sep 10, 2021
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 6246 CT Primary

Addresses

Primary practice location

33 Pendleton Dr
Hebron, CT 06248-1512

Mailing address

55 Stoneridge Rd
Colchester, CT 06415-2348
Phone (860) 682-4248

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Therapeutics LLC Pediatrics CurrentSince Oct 13, 2024 Accepting new patients
Physiocare Physical Therapy and Sports Medicine, LLC PastSince Sep 12, 2021 Accepting new patients
Physiocare Physical Therapy and Sports Medicine, LLC PastSince Sep 12, 2021 Accepting new patients

Locations

33 Pendleton Dr
Hebron, CT 06248
Phone (860) 207-3665

33 Pendleton Dr
#A
Hebron, CT 06248

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1780353987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 STONERIDGE RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152348",
            "telephone_number": "860-682-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 PENDLETON DR",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481512",
            "telephone_number": "860-207-3665",
            "fax_number": "860-812-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CT",
            "license": "6246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hebron, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.