Active NPI
Bonnie L Locke, C.O.T.A.
- Occupational Therapy Assistant
- Waco, TX
National Provider Identifier
1174795702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 210140
- Practice address
- 2501 Maple Ave
Waco, TX 76707-1337 - Phone
- (866) 724-8555
- NPI assigned
- Mar 24, 2008
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 210140 | TX | Primary |
Addresses
Primary practice location
2501 Maple Ave
Waco, TX 76707-1337
Mailing address
48315 Walden
Macomb, MI 48044
Phone (586) 909-3660
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
| License | State | Type | Specialty |
|---|---|---|---|
| 210140 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1174795702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48315 WALDEN",
"city": "MACOMB",
"state": "MI",
"postal_code": "48044",
"telephone_number": "586-909-3660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 MAPLE AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767071337",
"telephone_number": "866-724-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKE",
"first_name": "BONNIE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "C.O.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-24",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "210140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.