Cicero Offemaria Bermundo

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.007924 Issued in IL

Practice address

620 Warrington Ave
Danville, IL 61832-5446

Phone

(217) 446-0660

NPI assigned

Feb 20, 2018

Last updated

Feb 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1720588304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 LAWNDALE DR",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618322244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WARRINGTON AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325446",
            "telephone_number": "217-446-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUNDO",
        "first_name": "CICERO",
        "middle_name": "OFFEMARIA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043112534",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.007924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Marie Bell, PHARMACIST
• Jeremy N Bell, BSW
• Susan Berg, MD
• Nadia C Berger, MSW
• Milia Beth Bergkoetter, MS MFCC LCPC
• Brie Morgan Bertges, QMHP, LPC, CADC
• Lindsey Betout, APRN
• Christopher Bey, BS
• Bhirom Buranakul MD LLC
• Ocean L Biggers-Richardson, BA, MHP

• Physical Therapy Assistant in Danville, IL
• Providers in Danville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.