Bonnie Larsen

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

6609718-4201 Issued in UT

Practice address

100 Mario Capecchi Dr
SLC, UT 84113-1103

Phone

(801) 755-3792

NPI assigned

Aug 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  dba Intermountain Physical Therapy and Rehabilitation

  • Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033822085
  Medicare reassignment NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1578962007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 UNIVERSITY VLG",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841083505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-755-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "BONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "UT",
            "license": "6609718-4201",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "UT",
            "license": "6609718-4201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Landward
• Brandon Lane
• Heidi D Lane, PT
• Mark Vincent Lange, MPT
• Nancy Langman Axtell
• Bryan Steele Larson, DDS
• Dave Scott Larson, PT
• Matthew G. Larson, LCSW
• Mary June Latu, LCSW
• Madeline Lauder

• Neurorehabilitation Occupational Therapist in SLC, UT
• Providers in SLC, UT by specialty
• Neurorehabilitation Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.