Active NPI
Bonnidene Marie Maglio, LPTA
- Physical Therapy Assistant
- Brookfield, WI
National Provider Identifier
1336332188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 167019
- Practice address
- 18740 W Bluemound Rd
Brookfield Rehab & Specialty Care
Brookfield, WI 53005 - Phone
- (262) 782-0230
- Fax
- (262) 797-8306
- NPI assigned
- Aug 24, 2007
- 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 Therapy Assistant | 225200000X | 167019 | Primary |
Addresses
Primary practice location
18740 W Bluemound Rd
Brookfield Rehab & Specialty Care
Brookfield, WI 53005
Mailing address
18740 W Bluemound Rd
Brookfield Rehab & Specialty Care
Brookfield, WI 53005
Phone (262) 782-0230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40187300 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1336332188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18740 W BLUEMOUND RD",
"address_2": "BROOKFIELD REHAB & SPECIALTY CARE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53005",
"telephone_number": "262-782-0230",
"fax_number": "262-797-8306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18740 W BLUEMOUND RD",
"address_2": "BROOKFIELD REHAB & SPECIALTY CARE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53005",
"telephone_number": "262-782-0230",
"fax_number": "262-797-8306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGLIO",
"first_name": "BONNIDENE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-24",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": "167019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40187300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}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 Aug 24, 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.