Individual provider Active NPI

Jane Bomer, M.O.T., O.T.R.

  • Occupational Therapist
  • Conroe, TX
National Provider Identifier
1184753550
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
304475 Issued in TX
Practice address
4015 Interstate 45 N
Conroe, TX 77304-4901
Phone
(936) 522-4731
Fax
(936) 522-4737
NPI assigned
Mar 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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 304475 TX Primary

Addresses

Primary practice location

4015 Interstate 45 N
Conroe, TX 77304-4901

Mailing address

4015 Interstate 45 N
Conroe, TX 77304-4901
Phone (936) 522-4731

Other names 1

  • Jane Ronzio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000260 TX Practitioner - Occupational Therapist in Private Practice 8527142421 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304475TXMDOccupational Therapist
112178TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership CurrentSince Apr 1, 2025 Accepting new patients
Fox Rehabilitation Services TX LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Dec 15, 2022 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist CurrentSince Dec 15, 2022 Accepting new patients
Select Physical Therapy Texas Limited Partnership CurrentSince Apr 1, 2025 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

4101 W Arkansas Ln
Arlington, TX 76016
Phone (817) 469-7671

6327 Cypresswood Dr
Spring, TX 77379
Phone (281) 374-1750

8101 Cypresswood Dr
Ste 250
Spring, TX 77379
Phone (281) 376-3900

711 W Bay Area Blvd
Ste 608
Webster, TX 77598
Phone (281) 338-1273

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1184753550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-522-4731",
            "fax_number": "936-522-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-522-4731",
            "fax_number": "936-522-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMER",
        "first_name": "JANE",
        "name_prefix": "Miss",
        "credential": "M.O.T., O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "304475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "RONZIO",
            "credential": "MOT OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.