Individual provider Active NPI

Bonnie Keaton, OTR

  • Pediatric Occupational Therapist
  • Coral Springs, FL
National Provider Identifier
1528101243
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT12463 Issued in FL
Practice address
10168 W Sample Rd
Coral Springs, FL 33065-3938
Phone
(954) 753-4441
Fax
(954) 346-8139
NPI assigned
Feb 14, 2007
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT12463 FL Primary

Addresses

Primary practice location

10168 W Sample Rd
Coral Springs, FL 33065-3938

Mailing address

6063 Grand Cypress Cir W
Coconut Creek, FL 33073-2341
Phone (386) 697-6430

Other identifiers 1

IdentifierTypeStateIssuer
891745100MedicaidFL

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
OT12463FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1528101243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6063 GRAND CYPRESS CIR W",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732341",
            "telephone_number": "386-697-6430",
            "fax_number": "954-227-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10168 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653938",
            "telephone_number": "954-753-4441",
            "fax_number": "954-346-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATON",
        "first_name": "BONNIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT12463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891745100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.