Individual provider Active NPI

Debra L Vince, COTA

  • Occupational Therapy Assistant
  • Wallingford, CT
National Provider Identifier
1982926150
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0000028 Issued in CT
Practice address
35 Marc Dr
Wallingford, CT 06492-5708
Phone
(203) 265-0982
NPI assigned
Feb 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0000028 CT Primary

Addresses

Primary practice location

35 Marc Dr
Wallingford, CT 06492-5708

Mailing address

35 Marc Dr
Wallingford, CT 06492-5708
Phone (203) 265-0981

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

LicenseStateTypeSpecialty
0000028CTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1982926150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MARC DR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925708",
            "telephone_number": "203-265-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MARC DR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925708",
            "telephone_number": "203-265-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCE",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "0000028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.