Kristen Nicole Bosse, MMS, OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT10804 Issued in FL

Practice address

4978 SW 90TH Ter
Cooper City, FL 33328-3517

Phone

(954) 434-4276

Fax

(954) 252-8459

NPI assigned

Mar 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1124145982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4978 SW 90TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333283517",
            "telephone_number": "954-434-4276",
            "fax_number": "954-252-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4978 SW 90TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333283517",
            "telephone_number": "954-434-4276",
            "fax_number": "954-252-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSE",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MMS, OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT10804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8887551",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Victoria Branker
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• Angela Camilli

• Pediatric Occupational Therapist in Cooper City, FL
• Providers in Cooper City, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.