Active NPI
Michelle Bonang
- Occupational Therapist
- Weston, VT
National Provider Identifier
1700117140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0720000579
- Practice address
- 84 Lawrence Hill Rd
Weston, VT 05161-5602 - Phone
- (802) 289-2930
- NPI assigned
- Jan 25, 2010
- Last updated
- Aug 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 0720000579 | VT | Primary |
Addresses
Primary practice location
84 Lawrence Hill Rd
Weston, VT 05161-5602
Mailing address
84 Lawrence Hill Rd
Weston, VT 05161-5602
Phone (802) 289-2930
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 |
|---|---|---|---|
| 0720000579 | VT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471651200000",
"number": "1700117140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 LAWRENCE HILL RD",
"city": "WESTON",
"state": "VT",
"postal_code": "051615602",
"telephone_number": "802-289-2930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 LAWRENCE HILL RD",
"city": "WESTON",
"state": "VT",
"postal_code": "051615602",
"telephone_number": "802-289-2930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONANG",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-25",
"last_updated": "2016-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VT",
"license": "0720000579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.