NPIMap

Individual provider Active NPI

Jennifer L Bonano, MS, OTR/L

  • Occupational Therapist
  • Durham, NC
National Provider Identifier
1134462872
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8630 Issued in NC
Practice address
3514 University Dr
Suite 8
Durham, NC 27707-6247
Phone
(919) 493-7002
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8630 NC Primary

Addresses

Primary practice location

3514 University Dr
Suite 8
Durham, NC 27707-6247

Mailing address

3514 University Drive
Suite 8
Durham, NC 27707
Phone (919) 493-7002

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 Science

State licenses

LicenseStateTypeSpecialty
8630NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Village Therapy, PLLC Occupational Therapist Current Accepting new patients
Developmental Therapy Associates, Inc. Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1134462872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 UNIVERSITY DRIVE",
            "address_2": "SUITE 8",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27707",
            "telephone_number": "919-493-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 UNIVERSITY DR",
            "address_2": "SUITE 8",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076247",
            "telephone_number": "919-493-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.