Individual provider Active NPI

Stacie Lynn Griffin, MS, OTR/L

  • Occupational Therapist
  • South Boston, VA
National Provider Identifier
1053742346
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119005547 Issued in VA
Practice address
1438 Seymour Dr
South Boston, VA 24592-3916
Phone
(434) 517-9947
NPI assigned
Dec 11, 2013
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119005547 VA Primary

Addresses

Primary practice location

1438 Seymour Dr
South Boston, VA 24592-3916

Mailing address

175 Deer Run Rd
Danville, VA 24540-2863
Phone (434) 797-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106000806 VA Practitioner - Occupational Therapist in Private Practice 8921532508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0119005547VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bodyworks Physical Therapy and Rehabilitation Occupational Therapist CurrentSince Aug 1, 2024 Accepting new patients
Center for Pediatric Therapies, Inc. Past Accepting new patients
Danville Orthopedic and Athletic Rehabilitation, Inc. Occupational Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1053742346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 DEER RUN RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402863",
            "telephone_number": "434-797-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 SEYMOUR DR",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245923916",
            "telephone_number": "434-517-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.