Individual provider Active NPI

Ebony Bradby

  • Occupational Therapist
  • Hampton, VA
National Provider Identifier
1942935184
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119009562 Issued in VA
Practice address
1062 W Mercury Blvd
Hampton, VA 23666-1068
Phone
(757) 223-1466
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 0119009562 VA Primary

Addresses

Primary practice location

1062 W Mercury Blvd
Hampton, VA 23666-1068

Mailing address

173 Lane Cres
Smithfield, VA 23430-5844
Phone (757) 647-6855

Other practice location 1

710 Mobjack Pl
Newport News, VA 23606-1957
Phone (757) 260-5507

Other practice location 2

67 Red Robin Turn
Hampton, VA 23669-5914
Phone (757) 880-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506000145 VA Practitioner - Occupational Therapist in Private Practice 7416474283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119009562VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Speech Therapy LLC Occupational Therapist CurrentSince May 4, 2025 Accepting new patients

Locations

710 Mobjack Pl
Newport News, VA 23606
Phone (757) 240-2571

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1942935184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 LANE CRES",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234305844",
            "telephone_number": "757-647-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 W MERCURY BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661068",
            "telephone_number": "757-223-1466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Mobjack Pl",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236061957",
            "country_code": "US",
            "telephone_number": "757-260-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 Red Robin Turn",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236695914",
            "country_code": "US",
            "telephone_number": "757-880-2468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADBY",
        "first_name": "EBONY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.