Active NPI
Bonnie Taylor Davis, PT
- Physical Therapist
- Bowie, MD
National Provider Identifier
1174918262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 25405
- Practice address
- 6842 Race Track Rd Ste B
Bowie, MD 20715-3011 - Phone
- (240) 544-0200
- Fax
- (301) 464-1053
- NPI assigned
- Apr 6, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 25405 | MD | Primary |
Addresses
Primary practice location
6842 Race Track Rd Ste B
Bowie, MD 20715-3011
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other names 1
- Bonnie Botts
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25405 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1174918262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6842 RACE TRACK RD STE B",
"city": "BOWIE",
"state": "MD",
"postal_code": "207153011",
"telephone_number": "240-544-0200",
"fax_number": "301-464-1053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BONNIE",
"middle_name": "TAYLOR",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "25405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "BOTTS",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.