Carla Mangine, OTR/L

Individual provider Active NPI Occupational Therapist · Ruckersville, VA

NPI 1972029957 · NPPES record last updated Jan 3, 2020

Key facts

NPI
1972029957
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
138 Stoneridge Dr N Ste 4
Ruckersville, VA 22968-3063
Phone
(434) 985-2288
Fax
(434) 985-6909
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Developmental Disabilities Center Past Accepting new patients
Developmental Disabilities Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Yes

Addresses

Primary practice location

138 Stoneridge Dr N Ste 4
Ruckersville, VA 22968-3063

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Other identifiers

IdentifierTypeStateIssuer
OT.0000956OtherCOINSURANCE
OT.0000956MedicaidCO

Other providers in Ruckersville, VA

All providers in Ruckersville, VA · Occupational Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.