Active NPI
Bonnie Kay Pine, O.T.R.
- Occupational Therapist
- Plano, TX
National Provider Identifier
1124146964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 105845
- Practice address
- 5745 Bozeman Dr Apt 8211
Plano, TX 75024-5781 - Phone
- (214) 293-8020
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 105845 | TX | Primary |
Addresses
Primary practice location
5745 Bozeman Dr Apt 8211
Plano, TX 75024-5781
Mailing address
5745 Bozeman Dr Apt 8211
Plano, TX 75024-5781
Phone (214) 293-8020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110401000853 | TX | Practitioner - Occupational Therapist in Private Practice | 8527242353 | Practice locations: Plano, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105845 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1124146964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5745 BOZEMAN DR APT 8211",
"city": "PLANO",
"state": "TX",
"postal_code": "750245781",
"telephone_number": "214-293-8020",
"fax_number": "972-380-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5745 BOZEMAN DR APT 8211",
"city": "PLANO",
"state": "TX",
"postal_code": "750245781",
"telephone_number": "214-293-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINE",
"first_name": "BONNIE",
"middle_name": "KAY",
"name_prefix": "Miss",
"credential": "O.T.R.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "105845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.