Kelcie Richburg, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119007169 Issued in VA

Practice address

729 Thimble Shoals Blvd Ste 5-C1
Newport News, VA 23606-4217

Phone

(757) 863-9183

NPI assigned

Jun 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2015

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)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  Occupational Therapist, VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1184284184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 TODDS LN # 236",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663123",
            "telephone_number": "757-863-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE 5-C1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064217",
            "telephone_number": "757-863-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHBURG",
        "first_name": "KELCIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119007169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Richardson, PT
• Reginald Ryland Richardson, DAT, LAT, ATC
• Sarah Austin Richardson, CPNP-PC
• Shavonne Patriese Richardson
• Ayana Richburg, RBT
• Richey, Inc
• Iiesha Lasha Ricks, LCSW, LCSW-C, PH.D
• Shirley Gail Ricks
• Ricmolraw1, LLC
• Phillip Riddick, LCSW

• Occupational Therapist in Newport News, VA
• Providers in Newport News, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.