Individual provider Active NPI

Teronna Bosserman

  • Occupational Therapy Assistant
  • Heathrow, FL
National Provider Identifier
1003099987
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0P001615L Issued in PA
Practice address
1485 International Pkwy
Heathrow, FL 32746-5303
Phone
(800) 798-6035
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0P001615L PA Primary

Addresses

Primary practice location

1485 International Pkwy
Heathrow, FL 32746-5303

Mailing address

2308 Buckingham Ave
Mechanicsburg, PA 17055-5701
Phone (717) 691-5920

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0P001615LPAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1003099987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 BUCKINGHAM AVE",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170555701",
            "telephone_number": "717-691-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 INTERNATIONAL PKWY",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327465303",
            "telephone_number": "800-798-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERMAN",
        "first_name": "TERONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "0P001615L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heathrow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.