Individual provider Active NPI

Bonnie Jean Scott, PHYSICAL THERAPIST A

  • Physical Therapy Assistant
  • Brookfield, WI
National Provider Identifier
1184811432
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
983019 Issued in WI
Practice address
18740 W Bluemound Rd
Brookfield, WI 53045
Phone
(262) 782-0230
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 983019 WI Primary

Addresses

Primary practice location

18740 W Bluemound Rd
Brookfield, WI 53045

Mailing address

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

Other identifiers 1

IdentifierTypeStateIssuer
40154200MedicaidWI

Other names 1

  • Bonnie Jean Opper Former name

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
983019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1184811432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18740 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-782-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-782-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "983019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40154200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "OPPER",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.