Active NPI
Virginia Ann Graham, OT
- Occupational Therapist
- Dorchester, MA
National Provider Identifier
1063550184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1331
- Practice address
- 105 Victory Rd
Dorchester, MA 02122 - Phone
- (617) 371-3010
- NPI assigned
- Feb 1, 2007
- 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 | 1331 | MA | Primary |
Addresses
Primary practice location
105 Victory Rd
Dorchester, MA 02122
Mailing address
174 Adams St
Dedham, MA 02026-5020
Phone (781) 326-4506
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 |
|---|---|---|---|
| 1331 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063550184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 ADAMS ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265020",
"telephone_number": "781-326-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 VICTORY RD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02122",
"telephone_number": "617-371-3010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "VIRGINIA",
"middle_name": "ANN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "1331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.