Bonnie De Lane Koch, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5116 Issued in AZ

Practice address

13420 W San Pablo Dr
Sun City West, AZ 85375-6818

Phone

(719) 237-2649

NPI assigned

Jul 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1750636627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 W SAN PABLO DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756818",
            "telephone_number": "719-237-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 W SAN PABLO DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756818",
            "telephone_number": "719-237-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "BONNIE",
        "middle_name": "DE LANE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "5116",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "1054",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "HI",
            "license": "1081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kingfisher Family Medicine, PLLC
• Borislav T Kirov, M.D.
• Barry Stephan Kirschner, DDS
• KLM Enterprise, PLLC
• Jacob Tanner Kobernick, PA-C
• Amoa Tamara Kolbeck, MS, BCBA, LBA
• Molly Rose Kommer, PA-C
• Michael V Koss, MD
• Alyssa Marie Kotzbauer, SLP-CCC
• Nikolas Mathew Kozul, CRNA

• Pediatric Occupational Therapist in Sun City West, AZ
• Providers in Sun City West, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.