Active NPI
Priscilla Guill Powell, COTA
- Occupational Therapy Assistant
- South Boston, VA
National Provider Identifier
1104561844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0131002456
- Practice address
- 435 Hamilton Blvd
South Boston, VA 24592-5201 - Phone
- (434) 710-3451
- NPI assigned
- Apr 27, 2022
- 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 Therapy Assistant | 224Z00000X | 0131002456 | VA | Primary |
Addresses
Primary practice location
435 Hamilton Blvd
South Boston, VA 24592-5201
Mailing address
105 Calvin Rd
Ringgold, VA 24586-3001
Phone (434) 710-3451
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 |
|---|---|---|---|
| 0131002456 | VA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1104561844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CALVIN RD",
"city": "RINGGOLD",
"state": "VA",
"postal_code": "245863001",
"telephone_number": "434-710-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 HAMILTON BLVD",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245925201",
"telephone_number": "434-710-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "PRISCILLA",
"middle_name": "GUILL",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-27",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "0131002456",
"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 Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.