MEDICARE: KRISTI K GREGORY MS OTRL CHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0119003030	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00425882	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	192945	OTHER	VA	BCBS OCCUPATIONAL THERAPY
3	7261398	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1124084264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI K GREGORY MS OTRL CHT

Provider Business Mailing Address
First Line	:	PO BOX 715868
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19171-5868
Country	:	US
Telephone Number	:	804-915-1910
Fax Number	:	804-968-1803

Provider Business Practice Location Address
First Line	:	1115 BOULDERS PKWY STE 100A
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4067
Country	:	US
Telephone Number	:	804-379-9086
Fax Number	:	804-267-1673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/22/2026

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