Krystal Nicole Sage, COTA/L, QMHP-C

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131002528 Issued in VA

Practice address

927 N Main St
Marion, VA 24354-4117

Phone

(276) 783-7529

NPI assigned

Aug 19, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Kidz at Play Therapy, PLLC

  • Rehabilitation Clinic/Center
  • Marion, VA
  • NPI 1760753545

  Occupational Therapy Assistant

  NPD

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1639845696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 SUGAR GROVE HWY",
            "city": "SUGAR GROVE",
            "state": "VA",
            "postal_code": "243753140",
            "telephone_number": "276-685-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 N MAIN ST",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544117",
            "telephone_number": "276-783-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGE",
        "first_name": "KRYSTAL",
        "middle_name": "NICOLE",
        "credential": "COTA/L, QMHP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131002528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan E Rouse
• Royal Oak Family Dentistry, PLLC
• Royal Oak Medical Associates PC
• Royal Oak Medical Associates PC
• Royal Oak Pediatric Associates, Inc
• Maliha Salique
• Neal Ray Sanders, M.D.
• Jessika Nikhole Schottelkotte, FNP
• Scott D. Burnop Odpc
• James U Scott, M.D.

• Occupational Therapy Assistant in Marion, VA
• Providers in Marion, 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 Aug 19, 2021; 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.