Active NPI
Pamela Grady, OT
- Occupational Therapist
- Stafford, VA
National Provider Identifier
1376905612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119002618
- Practice address
- 29 Bruce St
Stafford, VA 22554-6581 - Phone
- (540) 720-7929
- NPI assigned
- Mar 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 0119002618 | VA | Primary |
Addresses
Primary practice location
29 Bruce St
Stafford, VA 22554-6581
Mailing address
29 Bruce St
Stafford, VA 22554-6581
Phone (540) 720-7929
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 |
|---|---|---|---|
| 0119002618 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458864000000",
"number": "1376905612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BRUCE ST",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225546581",
"telephone_number": "540-720-7929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BRUCE ST",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225546581",
"telephone_number": "540-720-7929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "PAMELA",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-25",
"last_updated": "2016-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119002618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.