Individual provider Active NPI

Charlene Dismaya, OTR/L

  • Pediatric Occupational Therapist
  • Chesapeake, VA
National Provider Identifier
1083108278
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0119005382 Issued in VA
Practice address
2448 Shipyard Rd
Chesapeake, VA 23323-3905
Phone
(757) 558-5356
NPI assigned
Jun 20, 2018
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 0119005382 VA Primary

Addresses

Primary practice location

2448 Shipyard Rd
Chesapeake, VA 23323-3905

Mailing address

504 McKinzie CT
Chesapeake, VA 23320-3280
Phone (757) 513-8978

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
0119005382VAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1083108278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MCKINZIE CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203280",
            "telephone_number": "757-513-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 SHIPYARD RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233233905",
            "telephone_number": "757-558-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISMAYA",
        "first_name": "CHARLENE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119005382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.