Individual provider Active NPI

Taylor Boone

  • Occupational Therapist
  • Virginia Beach, VA
National Provider Identifier
1144769480
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119009243 Issued in VA
Practice address
3100 Shore Dr
Virginia Beach, VA 23451-1199
Phone
(757) 496-1688
NPI assigned
Feb 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131001270 VA
Occupational Therapist 225X00000X 0119009243 VA Primary

Addresses

Primary practice location

3100 Shore Dr
Virginia Beach, VA 23451-1199

Mailing address

1309 Kempsville Rd
Norfolk, VA 23502-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230403001091 VA Practitioner - Occupational Therapist in Private Practice 8820463912 Reassigns benefits to 1 organization
I20260602003603 DC Practitioner - Occupational Therapist in Private Practice 8820463912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

12052 N Shore Dr
Reston, VA 20190-4969
Phone (888) 531-2204

4560 Princess Anne Rd
Virginia Beach, VA 23462-7905
Phone (888) 531-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0131001270VAMDOccupational Therapy Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1144769480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 KEMPSVILLE RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511199",
            "telephone_number": "757-496-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131001270",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.