Active NPI
Kaitlyn Bonvillain, OTR/L
- Occupational Therapist
- Thibodaux, LA
National Provider Identifier
1861139180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 331043
- Practice address
- 1003 Saint Mary St
Thibodaux, LA 70301-6624 - Phone
- (985) 227-9116
- Fax
- (985) 227-9259
- NPI assigned
- May 18, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 331043 | LA | Primary |
Addresses
Primary practice location
1003 Saint Mary St
Thibodaux, LA 70301-6624
Mailing address
1003 Saint Mary St
Thibodaux, LA 70301-6624
Phone (985) 227-9116
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331043 | LA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1861139180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 SAINT MARY ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703016624",
"telephone_number": "985-227-9116",
"fax_number": "985-227-9259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 SAINT MARY ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703016624",
"telephone_number": "985-227-9116",
"fax_number": "985-227-9259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONVILLAIN",
"first_name": "KAITLYN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-18",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "LA",
"license": "331043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.