Mary Grace Rafanan

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131000985 Issued in VA

Practice address

1015 W 47TH St
Norfolk, VA 23529-0001

Phone

(757) 683-7041

NPI assigned

Mar 11, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Old Dominion University

  • Physical Therapist
  • Norfolk, VA
  • NPI 1871929729
  NPD (past)

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1629439013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 REDLEAFE CIR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W 47TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235290001",
            "telephone_number": "757-683-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFANAN",
        "first_name": "MARY GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radiant Pride Therapy PLLC
• Radiant Shore Living LLC
• Radical Recovery Treatment Center Inc
• James Kent Radike, M.D.
• Kirsten Leigh Raeber, PT
• Erin Rafferty
• Shamari Ragguette
• Sharon A Raghubar, DDS
• Thomas Hall Ragsdale, MD
• Naved Rahim, PHARM.D.

• Occupational Therapy Assistant in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.