Individual provider Active NPI

Rhonda Boertmann

  • Occupational Therapy Assistant
  • Deltona, FL
National Provider Identifier
1154524015
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA9565 Issued in FL
Practice address
1666 Monica St
Deltona, FL 32725-3968
Phone
(386) 789-0124
Fax
(386) 532-1374
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA9565 FL Primary

Addresses

Primary practice location

1666 Monica St
Deltona, FL 32725-3968

Mailing address

1666 Monica St
Deltona, FL 32725-3968
Phone (386) 789-0124

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

State licenses

LicenseStateTypeSpecialty
OTA9565FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154524015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 MONICA ST",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327253968",
            "telephone_number": "386-789-0124",
            "fax_number": "386-532-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 MONICA ST",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327253968",
            "telephone_number": "386-789-0124",
            "fax_number": "386-532-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERTMANN",
        "first_name": "RHONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA9565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.