Bettina Bourda, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056011398 Issued in IL

Practice address

424 E Central Blvd
Ste 378
Orlando, FL 32801-1923

Phone

(407) 219-4367

NPI assigned

Jun 18, 2010

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

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bellah Therapies LLC

  • Physical Therapist
  • Harker Heights, TX
  • NPI 1790157964
  Medicare reassignment

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1801117270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 WISCONSIN AVE APT 2D",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023413",
            "fax_number": "407-219-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E CENTRAL BLVD",
            "address_2": "STE 378",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011923",
            "telephone_number": "407-219-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDA",
        "first_name": "BETTINA",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112621",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "14270",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Boulier, MS, RD, LDN, CNSC
• Tharwat Stewart Fouad Boulis, MD
• Lisa Jeanne Bouma Hernandez, MD
• Marsha Ann Bounds, ARNP
• Michelle Lee Bourassa, MA
• Virginia Milagros Bouret
• Anissa Lynn Bourgeacq, RDN
• Bourillon Solutions LLC
• Anthony Bourne
• Shelby Jean Bournival

• Occupational Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.