Kathleen Ann Subasic, OTR/L

Primary specialty

Environmental Modification Occupational TherapistTaxonomy code 225XE0001X

License

04200 Issued in MD

Practice address

19 Stockbridge Dr
Avon, CT 06001

Phone

(860) 829-7870

NPI assigned

Jan 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1851809974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 STOCKBRIDGE DR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014415",
            "telephone_number": "860-829-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 STOCKBRIDGE DR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-829-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Stockbridge Dr",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "CT",
            "postal_code": "060014415",
            "country_code": "US",
            "telephone_number": "860-829-7870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Rayville Rd",
            "address_purpose": "LOCATION",
            "city": "Parkton",
            "state": "MD",
            "postal_code": "211209056",
            "country_code": "US",
            "telephone_number": "410-812-1916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBASIC",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "MD",
            "license": "04200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Avon, CT
• Providers in Avon, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.