Active NPI
Traci Canavan, OTR/L, ATRIC
- Occupational Therapist
- Branford, CT
National Provider Identifier
1982948238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 001614
- Practice address
- 26 River Rd
Branford, CT 06405-5041 - Phone
- (203) 988-5191
- NPI assigned
- Nov 26, 2012
- 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 | 001614 | CT | Primary |
Addresses
Primary practice location
26 River Rd
Branford, CT 06405-5041
Mailing address
26 River Rd
Branford, CT 06405-5041
Phone (203) 988-5191
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 |
|---|---|---|---|
| 001614 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoreline Aquatic Therapy, 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.
-
- Developmentally Disabled Services Day Training Agency
- Branford, CT
- NPI 1831438712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1982948238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 RIVER RD",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064055041",
"telephone_number": "203-988-5191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 RIVER RD",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064055041",
"telephone_number": "203-988-5191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANAVAN",
"first_name": "TRACI",
"name_prefix": "Ms.",
"credential": "OTR/L, ATRIC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-26",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "001614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Branford, CT
- Tamra Camarota Lacroix, PT, MS
- Lisa Rae Camera, P.T.
- Georgette Campano Campano Wood, LPC MENTAL HEALTH CO
- Leonard J Campion Jr.
- Alexa Canavan, APRN-C
- Kathleen Marie Capen, MSW
- Erin Brianna Carey Hearn, BCBA, LBA
- Shawn Lawrence Cariglio, OTR/L
- Patricia Helen Carl-Stannard, LCSW
- Carofano Opticians Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.