Individual provider Active NPI

Katie Boshoven, OTR/L

  • Occupational Therapist
  • Chesapeake, VA
National Provider Identifier
1801408075
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700
Phone
(757) 270-4110
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 Primary

Addresses

Primary practice location

4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700

Mailing address

4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700
Phone (757) 270-4110

Other identifiers 1

IdentifierTypeStateIssuer
0119008727OtherVAVIRGINIA DEPARTMENT OF HEALTH PROFESSIONAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica@tidewatertherapy.com Health Information Exchange (HIE) Tidewater Therapy for Children, PC

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

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1801408075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 RAINTREE RD STE 100A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213700",
            "telephone_number": "757-270-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 RAINTREE RD STE 100A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213700",
            "telephone_number": "757-270-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSHOVEN",
        "first_name": "KATIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONAL",
            "identifier": "0119008727",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica@tidewatertherapy.com",
            "affiliation": "Y",
            "affiliationName": "Tidewater Therapy for Children, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4016 Raintree Rd",
            "address_2": "Suite 240",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233213700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.