Active NPI
Bonnie Roorda, PHD, ATC
- Athletic Trainer
- Southern Shores, NC
National Provider Identifier
1043699127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 012600280
- Practice address
- 26 Spindrift TRL
Southern Shores, NC 27949-3721 - Phone
- (252) 305-0121
- NPI assigned
- May 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 012600280 | VA | Primary |
Addresses
Primary practice location
26 Spindrift TRL
Southern Shores, NC 27949-3721
Mailing address
26 Spindrift TRL
Southern Shores, NC 27949-3721
Phone (252) 305-0121
Other names 1
- Bonnie Van Lunen
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012600280 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432252800000",
"number": "1043699127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 SPINDRIFT TRL",
"city": "SOUTHERN SHORES",
"state": "NC",
"postal_code": "279493721",
"telephone_number": "252-305-0121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 SPINDRIFT TRL",
"city": "SOUTHERN SHORES",
"state": "NC",
"postal_code": "279493721",
"telephone_number": "252-305-0121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROORDA",
"first_name": "BONNIE",
"credential": "PHD, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-22",
"last_updated": "2015-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "012600280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "VAN LUNEN",
"credential": "PHD, ATC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Southern Shores, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.