Active NPI
Mary J. Bridle, MA, OTL
- Occupational Therapist
- Charlottesville, VA
National Provider Identifier
1063473734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119000064
- Practice address
- 696 Berkmar Cir
Charlottesville, VA 22901-1464 - Phone
- (434) 817-4100
- Fax
- (434) 817-4101
- NPI assigned
- Mar 31, 2006
- 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 | 0119000064 | VA | Primary |
Addresses
Primary practice location
696 Berkmar Cir
Charlottesville, VA 22901-1464
Mailing address
696 Berkmar Cir
Charlottesville, VA 22901-1464
Phone (434) 817-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104332 | Other | VA | ANTHEM |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119000064 | VA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Sept, LLC | Occupational Therapist | 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.
-
- Physical Medicine & Rehabilitation Physician
- Verona, VA
- NPI 1235955709
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063473734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "696 BERKMAR CIR",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229011464",
"telephone_number": "434-817-4100",
"fax_number": "434-817-4101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "696 BERKMAR CIR",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229011464",
"telephone_number": "434-817-4100",
"fax_number": "434-817-4101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDLE",
"first_name": "MARY",
"middle_name": "J.",
"credential": "MA, OTL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119000064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "104332",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.