Individual provider Active NPI

Bonnie Sue Rheault, LMT

  • Massage Therapist
  • Altamonte Springs, FL
National Provider Identifier
1013285675
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA48041 Issued in FL
Practice address
224 W Central Pkwy
Suite 1010
Altamonte Springs, FL 32714-2545
Phone
(407) 697-0697
Fax
(407) 668-4100
NPI assigned
Dec 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA48041 FL Primary

Addresses

Primary practice location

224 W Central Pkwy
Suite 1010
Altamonte Springs, FL 32714-2545

Mailing address

645 Elm Creek CT
Altamonte Springs, FL 32714-1818
Phone (407) 697-0697

Other names 1

  • Bonnie Rheault Wyzykowski Former name

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
MA48041FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1013285675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 ELM CREEK CT",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141818",
            "telephone_number": "407-697-0697",
            "fax_number": "407-668-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W CENTRAL PKWY",
            "address_2": "SUITE 1010",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142545",
            "telephone_number": "407-697-0697",
            "fax_number": "407-668-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEAULT",
        "first_name": "BONNIE",
        "middle_name": "SUE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA48041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "WYZYKOWSKI",
            "middle_name": "RHEAULT",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.