Individual provider Active NPI

Shunaka Grayson White, OTR/L, CAPS, ECHM

  • Occupational Therapist
  • Stafford, VA
National Provider Identifier
1679721039
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119006450 Issued in VA
Practice address
532 Gladiola Way
Stafford, VA 22554-6848
Phone
(202) 696-0634
Fax
(540) 657-3664
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119006450 VA Primary
Occupational Therapist 225X00000X 3551 TN

Addresses

Primary practice location

532 Gladiola Way
Stafford, VA 22554-6848

Mailing address

532 Gladiola Way
Stafford, VA 22554-6848
Phone (202) 696-0634

Other names 1

  • Ms. Shunaka Trenise Grayson Other name

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

State licenses

LicenseStateTypeSpecialty
0119006450VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1679721039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 GLADIOLA WAY",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225546848",
            "telephone_number": "202-696-0634",
            "fax_number": "540-657-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 GLADIOLA WAY",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225546848",
            "telephone_number": "202-696-0634",
            "fax_number": "540-657-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHUNAKA",
        "middle_name": "GRAYSON",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CAPS, ECHM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006450",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUNAKA",
            "last_name": "GRAYSON",
            "middle_name": "TRENISE",
            "prefix": "MS.",
            "credential": "OTR/L, CAPS, ECHM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 22, 2025; 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.