Individual provider Active NPI

Kristin Slezak, OTR/L

  • Pediatric Occupational Therapist
  • Newport News, VA
National Provider Identifier
1265619100
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0119003641 Issued in VA
Practice address
729 Thimble Shoals Blvd Ste 4C
Newport News, VA 23606-4217
Phone
(757) 873-2932
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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 0119003641 VA Primary

Addresses

Primary practice location

729 Thimble Shoals Blvd Ste 4C
Newport News, VA 23606-4217

Mailing address

729 Thimble Shoals Blvd Ste 4C
Newport News, VA 23606-4217
Phone (757) 873-2932

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
0119003641VAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Physical Therapy & Associates Inc. Pediatrics Past Accepting new patients

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1265619100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE 4C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064217",
            "telephone_number": "757-873-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE 4C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064217",
            "telephone_number": "757-873-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEZAK",
        "first_name": "KRISTIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119003641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.