Active NPI
Rebecca Blair Bonin, MA OTR/L
- Occupational Therapist
- Fort Gordon, GA
National Provider Identifier
1073628111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 963
- Practice address
- 300 Hospital Rd
Fort Gordon, GA 30905-5741 - Phone
- (706) 787-1056
- NPI assigned
- Aug 20, 2006
- Last updated
- Jul 31, 2023
- 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 | 963 | GA | Primary |
Addresses
Primary practice location
300 Hospital Rd
Fort Gordon, GA 30905-5741
Mailing address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone (706) 787-1056
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 963 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1073628111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W HOSPITAL RD",
"city": "FORT EISENHOWER",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "706-787-1056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HOSPITAL RD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "706-787-1056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONIN",
"first_name": "REBECCA",
"middle_name": "BLAIR",
"name_prefix": "Ms.",
"credential": "MA OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.