Healthcare Provider Details

I. General information

NPI: 1467389403
Provider Name (Legal Business Name): KELLY RAMAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WESTBROOK AVE STE 134
RICHMOND VA
23227-3326
US

IV. Provider business mailing address

11830 EXPLORER CT
MIDLOTHIAN VA
23114-5307
US

V. Phone/Fax

Practice location:
  • Phone: 804-256-2092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number0131003135
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: