Active NPI
Caleb Bonner, OTR
- Occupational Therapist
- Selma, AL
National Provider Identifier
1558078402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5783
- Practice address
- 100 Park PL
Selma, AL 36701-7743 - Phone
- (334) 872-3471
- NPI assigned
- Oct 31, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5783 | AL | Primary |
Addresses
Primary practice location
100 Park PL
Selma, AL 36701-7743
Mailing address
388 Hoggle Rd
Valley Grande, AL 36701-9141
Phone (205) 457-4151
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5783 | AL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1558078402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "388 HOGGLE RD",
"city": "VALLEY GRANDE",
"state": "AL",
"postal_code": "367019141",
"telephone_number": "205-457-4151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PARK PL",
"city": "SELMA",
"state": "AL",
"postal_code": "367017743",
"telephone_number": "334-872-3471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "CALEB",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-31",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "5783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selma, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.