Individual provider Active NPI

Eileen Frances Centuolo, OTRL

  • Occupational Therapist
  • Chase City, VA
National Provider Identifier
1740313832
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119002993 Issued in VA
Practice address
5539 Highway Forty Seven
Chase City, VA 23924-3727
Phone
(434) 372-4063
Fax
(434) 372-4162
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0119002993VAMDOccupational Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119002993 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

5539 Highway Forty Seven
Chase City, VA 23924-3727

Mailing address

2140 Bellevue Rd
Halifax, VA 24558-2672

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740313832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 BELLEVUE RD",
            "city": "HALIFAX",
            "state": "VA",
            "postal_code": "245582672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5539 HIGHWAY FORTY SEVEN",
            "city": "CHASE CITY",
            "state": "VA",
            "postal_code": "239243727",
            "telephone_number": "434-372-4063",
            "fax_number": "434-372-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTUOLO",
        "first_name": "EILEEN",
        "middle_name": "FRANCES",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chase City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.