Dynamic Child

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

DYNAMIC CHILD

Practice address

175 Hartford Turnpike
Tolland, CT 06084

Phone

(860) 310-8676

NPI assigned

Feb 16, 2022

Last updated

Feb 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Regan Hillebrecht Walters, COTA/L

Title

Owner

Phone

(860) 310-8676

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Regan Hillebrecht, COTA/L

  • Specialist
  • Ellington, CT
  • NPI 1902265044
  NPD

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1821743113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 LAMB RD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060763313",
            "telephone_number": "860-310-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HARTFORD TURNPIKE",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "06084",
            "telephone_number": "860-310-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CHILD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "REGAN",
        "authorized_official_middle_name": "HILLEBRECHT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-310-8676",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114431038",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134593247",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225363070",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Echn Eldercare Services, Inc. (Woodlake at Tolland)
• Ecs-01 LLC (Senior Moments)
• Tracy Eissa
• Karen Ann Elliott, RPH
• Folasade Y Falana, PHD

• Pediatric Occupational Therapist in Tolland, CT
• Providers in Tolland, CT by specialty
• Pediatric Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.