Individual provider Active NPI

William Dibello Bonus, COTA/L

  • Environmental Modification Occupational Therapy Assistant
  • North Royalton, OH
National Provider Identifier
1861857955
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X
License
OTA.05509 Issued in OH
Practice address
13900 Bennett Rd
North Royalton, OH 44133-3808
Phone
(440) 237-7966
NPI assigned
Dec 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapy Assistant 224ZE0001X OTA.05509 OH Primary

Addresses

Primary practice location

13900 Bennett Rd
North Royalton, OH 44133-3808

Mailing address

7756 Harley Hills Dr
North Royalton, OH 44133-3662
Phone (440) 552-6451

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

LicenseStateTypeSpecialty
OTA.05509OHMDEnvironmental Modification Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1861857955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7756 HARLEY HILLS DR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333662",
            "telephone_number": "440-552-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 BENNETT RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333808",
            "telephone_number": "440-237-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONUS",
        "first_name": "WILLIAM",
        "middle_name": "DIBELLO",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "OH",
            "license": "OTA.05509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.