Jill Gwendolyn Bonell, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201001011 Issued in MI

Practice address

26001 Ford Rd
Dearborn Heights, MI 48127-2920

Phone

(313) 274-4600

NPI assigned

Nov 27, 2018

Last updated

Nov 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1114497633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26001 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272920",
            "telephone_number": "313-274-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272920",
            "telephone_number": "313-274-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012417",
            "country_code": "US",
            "telephone_number": "313-745-9751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONELL",
        "first_name": "JILL",
        "middle_name": "GWENDOLYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201001011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.