Individual provider Active NPI

Kristen Bonfiglio, OT

  • Occupational Therapist
  • Marrero, LA
National Provider Identifier
1669997094
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
306625 Issued in LA
Practice address
1050 Medical Center Blvd
Marrero, LA 70072-3144
Phone
(504) 347-0777
NPI assigned
Aug 7, 2017
Last updated
Aug 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 306625 LA Primary

Addresses

Primary practice location

1050 Medical Center Blvd
Marrero, LA 70072-3144

Mailing address

1020 W William David Pkwy
Metairie, LA 70005-1643
Phone (504) 715-8202

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
306625LAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crane Rehab Center LLC PastSince Jul 24, 2022 Accepting new patients
Crane Rehab Center Occupational Therapist PastSince Oct 2, 2022 Accepting new patients
Crane Rehab Center LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 3

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1669997094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W WILLIAM DAVID PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700051643",
            "telephone_number": "504-715-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723144",
            "telephone_number": "504-347-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFIGLIO",
        "first_name": "KRISTEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "306625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.