Active NPI
Bonny Marie Bray, O.T.R/L
- Occupational Therapist
- Aberdeen, MS
National Provider Identifier
1073993754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT0742
- Practice address
- 400 S Chestnut St
Aberdeen, MS 39730-3335 - Phone
- (662) 369-8200
- Fax
- (662) 369-8754
- NPI assigned
- Jun 8, 2015
- 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 | OT0742 | MS | Primary |
Addresses
Primary practice location
400 S Chestnut St
Aberdeen, MS 39730-3335
Mailing address
400 S Chestnut St
Aberdeen, MS 39730-3335
Phone (662) 369-8200
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 |
|---|---|---|---|
| OT0742 | MS | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enduracare Acute Care Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Franklin, TN
- NPI 1568975506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1073993754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S CHESTNUT ST",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397303335",
"telephone_number": "662-369-8200",
"fax_number": "662-369-8754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S CHESTNUT ST",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397303335",
"telephone_number": "662-369-8200",
"fax_number": "662-369-8754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAY",
"first_name": "BONNY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "O.T.R/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-08",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT0742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.