Individual provider Active NPI

Kelly Leonhardt Gragg, OTR/L

  • Occupational Therapist
  • Marion, VA
National Provider Identifier
1851914899
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119008556 Issued in VA
Practice address
927 N Main St
Marion, VA 24354-4117
Phone
(276) 783-7529
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 0119008556 VA Primary

Addresses

Primary practice location

927 N Main St
Marion, VA 24354-4117

Mailing address

1261 Whitetop Rd
Chilhowie, VA 24319-3626
Phone (828) 430-1783

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
0119008556VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz at Play Therapy, PLLC Single Specialty CurrentSince Aug 16, 2020 Accepting new patients

Locations

14418 Lee Hwy
Bristol, VA 24202
Phone (276) 783-7529

927 N Main St
Marion, VA 24354
Phone (276) 783-7259

Organizations & group practices 1

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1851914899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 WHITETOP RD",
            "city": "CHILHOWIE",
            "state": "VA",
            "postal_code": "243193626",
            "telephone_number": "828-430-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 N MAIN ST",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544117",
            "telephone_number": "276-783-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGG",
        "first_name": "KELLY",
        "middle_name": "LEONHARDT",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.