Individual provider Active NPI

Jessica L Bohnert, OTR

  • Pediatric Occupational Therapist
  • Covington, IN
National Provider Identifier
1609687920
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
1329 2ND St
Covington, IN 47932-1009
Phone
(765) 231-3180
NPI assigned
Jan 16, 2025
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 IN Primary

Addresses

Primary practice location

1329 2ND St
Covington, IN 47932-1009

Mailing address

2315 E Margaret Dr
Terre Haute, IN 47802-3340
Phone (812) 264-1395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212000269 IN Practitioner - Occupational Therapist in Private Practice 2264962836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1616 S 25TH St
Terre Haute, IN 47803-3697
Phone (812) 232-2118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc CurrentSince Feb 3, 2025 Accepting new patients
Legacy Healthcare Services, Inc. CurrentSince Feb 3, 2025 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (888) 654-1948

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1609687920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 E MARGARET DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023340",
            "telephone_number": "812-264-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 2ND ST",
            "city": "COVINGTON",
            "state": "IN",
            "postal_code": "479321009",
            "telephone_number": "765-231-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNERT",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.