Diane Kelly Davis

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119008183 Issued in VA

Practice address

1026 Jessie Dupont Memorial Hwy
Burgess, VA 22432-2038

Phone

(804) 220-2010

Fax

(804) 299-4061

NPI assigned

Jun 4, 2019

Last updated

Jun 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

For the Ages Rehabilitation LLCGroup PAC ID 4284151606, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• For the Ages Rehabilitation LLC

  • Physical Therapist
  • Reedville, VA
  • NPI 1538973045

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1932767928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 SANDY POINT RD",
            "city": "HEATHSVILLE",
            "state": "VA",
            "postal_code": "224734494",
            "telephone_number": "804-220-2010",
            "fax_number": "804-299-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 JESSIE DUPONT MEMORIAL HWY",
            "city": "BURGESS",
            "state": "VA",
            "postal_code": "224322038",
            "telephone_number": "804-220-2010",
            "fax_number": "804-299-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DIANE",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bay Harbor Med Center
• Burgess Behavioral Health Alternatives, LLC
• Leslie John Fina, D.D.S.
• Gma Stella Home Health Care Agency (Gma Stellas Home Health Care Agency)
• Sherilynn Hummel, M.D.
• Alfred Dunlap Hurt Jr., D.D.S.
• Melanie Lynne Nanan

• Occupational Therapist in Burgess, VA
• Providers in Burgess, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.