NPIMap

Organization Active NPI

Functional Performance Therapy, Inc.

  • Pediatric Occupational Therapist
  • Missoula, MT
National Provider Identifier
1811141914
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
FUNCTIONAL PERFORMANCE THERAPY, INC.
Practice address
901 SW Higgins Ave
Missoula, MT 59803-3600
Phone
(406) 214-2606
Fax
(406) 551-7300
NPI assigned
Nov 17, 2008
Last updated
Feb 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Edward A Boniecki, OT/LNPI 1639221559
Title
OT/Owner
Phone
(406) 214-2606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

901 SW Higgins Ave
Missoula, MT 59803-3600

Mailing address

PO Box 171
Florence, MT 59833-0171
Phone (406) 214-2606

National Provider Directory

National Provider Directory

Locations

3802 Eastside Hwy
Stevensville, MT 59870
Phone (406) 777-3523

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1811141914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598330171",
            "telephone_number": "406-214-2606",
            "fax_number": "406-551-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SW HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598033600",
            "telephone_number": "406-214-2606",
            "fax_number": "406-551-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PERFORMANCE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "BONIECKI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OT/OWNER",
        "authorized_official_telephone_number": "406-214-2606",
        "authorized_official_credential": "OT/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.