Active NPI
Bonnie Elizabeth Smith, OTR
- Occupational Therapist
- Orlando, FL
National Provider Identifier
1053440230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11391
- Practice address
- 215 E New Hampshire St
Orlando, FL 32804-6403 - Phone
- (407) 895-4400
- Fax
- (407) 264-8671
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11391 | FL | Primary |
Addresses
Primary practice location
215 E New Hampshire St
Orlando, FL 32804-6403
Mailing address
9826 Osprey Landing Dr
Orlando, FL 32832-5994
Phone (407) 895-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z139R | Other | FL | BLUE SHIELD OF FLORIDA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11391 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272499200000",
"number": "1053440230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9826 OSPREY LANDING DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328325994",
"telephone_number": "407-895-4400",
"fax_number": "407-264-8671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E NEW HAMPSHIRE ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328046403",
"telephone_number": "407-895-4400",
"fax_number": "407-264-8671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BONNIE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2010-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "11391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF FLORIDA",
"identifier": "Z139R",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.