Active NPI
Nicole Peloso Smith, OT
- Occupational Therapist
- Avon, CT
National Provider Identifier
1790080604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 003518
- Practice address
- 21 Waterville Rd
Allstar
Avon, CT 06001-2097 - Phone
- (860) 678-9755
- NPI assigned
- Jan 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 003518 | CT | Primary |
Addresses
Primary practice location
21 Waterville Rd
Allstar
Avon, CT 06001-2097
Mailing address
21 Waterville Rd
Allstar
Avon, CT 06001-2097
Phone (860) 678-9755
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003518 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Visiting Nurse & Home Health Care Agency, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Stratford, CT
- NPI 1215963822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1790080604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"address_2": "ALLSTAR",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-678-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"address_2": "ALLSTAR",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-678-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "NICOLE",
"middle_name": "PELOSO",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2021-08-16",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "003518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.