Active NPI
Gladys Nyambura Stackhouse, COTA
- Occupational Therapy Assistant
- West Hartford, CT
National Provider Identifier
1831590975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 098754278
- Practice address
- 100 Kane St
Apt. A3
West Hartford, CT 06119-2115 - Phone
- (860) 233-6501
- NPI assigned
- Sep 9, 2014
- 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 Therapy Assistant | 224Z00000X | 098754278 | CT | Primary |
Addresses
Primary practice location
100 Kane St
Apt. A3
West Hartford, CT 06119-2115
Mailing address
100 Kane St
Apt. A3
West Hartford, CT 06119-2115
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 |
|---|---|---|---|
| 098754278 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1831590975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KANE ST",
"address_2": "APT. A3",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061192115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 KANE ST",
"address_2": "APT. A3",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061192115",
"telephone_number": "860-233-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACKHOUSE",
"first_name": "GLADYS",
"middle_name": "NYAMBURA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "098754278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.