Individual provider Active NPI

Raymond Landrum, OTR/L

  • Occupational Therapist
  • Fredericksburg, VA
National Provider Identifier
1649935172
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119009049 Issued in VA
Practice address
3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone
(540) 479-4769
NPI assigned
Oct 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119009049 VA Primary

Addresses

Primary practice location

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000

Mailing address

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone (540) 479-4769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211120000224 VA Practitioner - Occupational Therapist in Private Practice 8123417706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119009049VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Nov 8, 2021 Accepting new patients
Mary Washington Healthcare Physicians Occupational Therapist CurrentSince Nov 8, 2021 Accepting new patients

Locations

3310 Fall Hill Ave
Fredericksburg, VA 22401
Phone (540) 373-7133

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

90 Greenspring Dr
Stafford, VA 22554
Phone (540) 373-7133

Organizations & group practices 2

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": "1635638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1649935172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 FALL HILL AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013000",
            "telephone_number": "540-479-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 FALL HILL AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013000",
            "telephone_number": "540-479-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "RAYMOND",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-31",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.