Tara Terina Bonilla, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

R3546 Issued in KY

Practice address

1740 Forest LN
Richmond, KY 40475-3638

Phone

(859) 779-3529

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

• The Weston Group Inc

  • Physical Therapist
  • Lexington, KY
  • NPI 1316056682
  Medicare reassignment

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1366640518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 FOREST LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753638",
            "telephone_number": "859-779-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 FOREST LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753638",
            "telephone_number": "859-779-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "TARA",
        "middle_name": "TERINA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R3546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boardman Family Chiropractic PSC
• Leanne Bober
• Kathryn Thor Boggs, PH.D.
• Nicholas Patrick Boland, DPT
• Sheriese Bone, LCSW
• Pradeep Bose, M.D.
• Radmila Bostock
• Courtney Marie Boulnemour, SLP
• Lori Bourgeois, ATC
• Jeffrey Lucas Bowen, D.M.D.

• Occupational Therapist in Richmond, KY
• Providers in Richmond, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.