Active NPI
Kelly Leonhardt Gragg, OTR/L
- Occupational Therapist
- Marion, VA
National Provider Identifier
1851914899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119008556
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0119008556 | VA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidz at Play Therapy, PLLC | Single Specialty | Current | 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.