Individual provider Active NPI

Theronica Roosetta Bond, MD

  • Physical Medicine & Rehabilitation Physician
  • Arlington, TX
National Provider Identifier
1871797357
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M7865 Issued in TX
Practice address
3200 Matlock Rd
Arlington, TX 76015
Phone
(817) 468-4000
Fax
(817) 284-3425
NPI assigned
Jun 11, 2007
Last updated
Jul 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X M7865 TX Primary

Addresses

Primary practice location

3200 Matlock Rd
Arlington, TX 76015

Mailing address

P O Box 678625
Dallas, TX 75267-8625
Phone (817) 284-9850

Other identifiers 2

IdentifierTypeStateIssuer
8AW000OtherTXBLUECROSS BLUESHIELD OF TEXAS
BP3-0018732OtherINSTITUTIONAL PERMIT

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physician Associates PLLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1871797357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 678625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678625",
            "telephone_number": "817-284-9850",
            "fax_number": "817-284-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76015",
            "telephone_number": "817-468-4000",
            "fax_number": "817-284-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND",
        "first_name": "THERONICA",
        "middle_name": "ROOSETTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M7865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF TEXAS",
            "identifier": "8AW000",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP3-0018732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.