Individual provider Active NPI

Gonul Gul Nazari, OTR/L

  • Occupational Therapist
  • Chesapeake, VA
National Provider Identifier
1912203548
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119005543 Issued in VA
Practice address
1301 Cedar Rd
Chesapeake, VA 23322-7105
Phone
(757) 512-7626
NPI assigned
Jan 29, 2011
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT60201986 WA
Occupational Therapist 225X00000X 46TR00562000 NJ
Occupational Therapist 225X00000X 10172 NC
Occupational Therapist 225X00000X 0119005543 VA Primary

Addresses

Primary practice location

1301 Cedar Rd
Chesapeake, VA 23322-7105

Mailing address

1301 Cedar Rd
Chesapeake, VA 23322-7105
Phone (757) 512-7626

Other practice location 1

225 White St
Jacksonville, NC 28546-6351
Phone (910) 353-7222

Other practice location 2

6106 Health Center Ln
Fredericksburg, VA 22407-6687
Phone (540) 785-1103

Other practice location 3

812 Shepard St
Morehead City, NC 28557-4250
Phone (252) 726-6855

Other practice location 4

516 23rd Ave SE
Puyallup, WA 98372-4659
Phone (253) 845-6631

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
10172NCMDPhysical Therapist
46TR00562000NJMDOccupational Therapist
0119005543VAMDOccupational Therapist
OT60201986WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Sept, LLC Occupational Therapist CurrentSince May 20, 2024 Accepting new patients
Ivyrehab Sept, LLC Occupational Therapist PastSince Jul 24, 2022 Accepting new patients

Locations

1301 Cedar Rd
Chesapeake, VA 23322
Phone (757) 512-7626

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1296259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1912203548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CEDAR RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233227105",
            "telephone_number": "757-512-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CEDAR RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233227105",
            "telephone_number": "757-512-7626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 White St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466351",
            "country_code": "US",
            "telephone_number": "910-353-7222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6106 Health Center Ln",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224076687",
            "country_code": "US",
            "telephone_number": "540-785-1103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "812 Shepard St",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285574250",
            "country_code": "US",
            "telephone_number": "252-726-6855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 23rd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983724659",
            "country_code": "US",
            "telephone_number": "253-845-6631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZARI",
        "first_name": "GONUL",
        "middle_name": "GUL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-29",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60201986",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00562000",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "10172",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jul 18, 2022; 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.