Individual provider Active NPI

Nicole Jeanette Galletta, OTRL

  • Occupational Therapist
  • Manakin Sabot, VA
National Provider Identifier
1821149709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119003178 Issued in VA
Practice address
40 Broad Street Rd
Manakin Sabot, VA 23103-2213
Phone
(804) 291-7926
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0119003178 VA Primary

Addresses

Primary practice location

40 Broad Street Rd
Manakin Sabot, VA 23103-2213

Mailing address

11118 Carrington Green Dr
Glen Allen, VA 23060-3446
Phone (804) 291-7926

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
0119003178VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821149709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11118 CARRINGTON GREEN DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603446",
            "telephone_number": "804-291-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROAD STREET RD",
            "city": "MANAKIN SABOT",
            "state": "VA",
            "postal_code": "231032213",
            "telephone_number": "804-291-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLETTA",
        "first_name": "NICOLE",
        "middle_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119003178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manakin Sabot, 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.