Active NPI
Bonnie Deloe Reitzel
- Child Mental Illness Respite Care
- Mesa, AZ
National Provider Identifier
1780740027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Mental Illness Respite Care
- License
- 8092
- Practice address
- 3716 E University Dr
#1009
Mesa, AZ 85205-6925 - Phone
- (602) 909-8375
- NPI assigned
- Dec 29, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | 8092 | AZ | Primary |
Addresses
Primary practice location
3716 E University Dr
#1009
Mesa, AZ 85205-6925
Mailing address
3716 E University Dr
#1009
Mesa, AZ 85205-6925
Phone (602) 909-8375
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 |
|---|---|---|---|
| 8092 | AZ | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780740027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3716 E UNIVERSITY DR",
"address_2": "#1009",
"city": "MESA",
"state": "AZ",
"postal_code": "852056925",
"telephone_number": "602-909-8375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 E UNIVERSITY DR",
"address_2": "#1009",
"city": "MESA",
"state": "AZ",
"postal_code": "852056925",
"telephone_number": "602-909-8375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REITZEL",
"first_name": "BONNIE",
"middle_name": "DELOE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "8092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.