Active NPI
Andre Bonge, OT
- Occupational Therapist
- Kansas City, MO
National Provider Identifier
1629376900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 005089
- Practice address
- 10330 Hickman Mills Dr
Building II
Kansas City, MO 64137-1618 - Phone
- (816) 501-5138
- Fax
- (816) 777-0626
- NPI assigned
- Mar 10, 2011
- Last updated
- Mar 10, 2011
- Sex
- Female
- 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 | 005089 | MO | Primary |
Addresses
Primary practice location
10330 Hickman Mills Dr
Building II
Kansas City, MO 64137-1618
Mailing address
10330 Hickman Mills Dr
Building II
Kansas City, MO 64137-1618
Phone (816) 501-5138
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 |
|---|---|---|---|
| 005089 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1629376900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 HICKMAN MILLS DR",
"address_2": "BUILDING II",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641371618",
"telephone_number": "816-501-5138",
"fax_number": "816-777-0626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10330 HICKMAN MILLS DR",
"address_2": "BUILDING II",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641371618",
"telephone_number": "816-501-5138",
"fax_number": "816-777-0626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGE",
"first_name": "ANDRE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "005089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.