Nicole Anne Bovkoon

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR2456 Issued in AR

Practice address

1301 Russell Rd
Russellville, AR 72802-4320

Phone

(479) 967-2316

Fax

(479) 967-3639

NPI assigned

Aug 10, 2011

Last updated

Mar 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nicole Anne Sinele Former name

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1174802987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728112109",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RUSSELL RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728024320",
            "telephone_number": "479-967-2316",
            "fax_number": "479-967-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVKOON",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "O-T1144",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188618721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SINELE",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Karl Bosold, APN
• Alicia M Bost, M.S.O.T.R.L.
• Stacey Marie Boster, MS,PT
• Timothy Isaac Bostick, CASE MANAGER PARAPRO
• Tommy Bourgeois, CASE MANAGER CARE CO
• Phillip Glen Bowden
• Benjamin Bower, MD
• Sherry Bowley, LPC
• Lauren Bowling, APRN
• Brenda Boyd

• Occupational Therapist in Russellville, AR
• Providers in Russellville, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.