Individual provider Active NPI

Alicia Small, MS OT/RL

  • Pediatric Occupational Therapist
  • Chesapeake, VA
National Provider Identifier
1629317862
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
07053 Issued in MD
Practice address
4016 Raintree Rd # 100a
Chesapeake, VA 23321-3700
Phone
(757) 488-2864
NPI assigned
Feb 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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 07053 MD Primary

Addresses

Primary practice location

4016 Raintree Rd # 100a
Chesapeake, VA 23321-3700

Mailing address

4016 Raintree Rd # 100a
Chesapeake, VA 23321-3700

Other practice location 1

15 Walker Ave
Pikesville, MD 21208-4023
Phone (410) 358-1997

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
07053MDMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1629317862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 RAINTREE RD # 100A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 RAINTREE RD # 100A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213700",
            "telephone_number": "757-488-2864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Walker Ave",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212084023",
            "country_code": "US",
            "telephone_number": "410-358-1997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ALICIA",
        "credential": "MS OT/RL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MD",
            "license": "07053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.