Individual provider Active NPI

Bonnie Maniker, MS OTR/L

  • Occupational Therapist
  • Bryn Mawr, PA
National Provider Identifier
1902316003
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC011695 Issued in PA
Practice address
113 Petrie Ave
Bryn Mawr, PA 19010-1510
Phone
(443) 223-9946
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC011695 PA Primary

Addresses

Primary practice location

113 Petrie Ave
Bryn Mawr, PA 19010-1510

Mailing address

113 Petrie Ave
Bryn Mawr, PA 19010-1510
Phone (443) 223-9946

Other identifiers 1

IdentifierTypeStateIssuer
OC011695OtherPAOT LICENSE

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OC011695PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1902316003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PETRIE AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101510",
            "telephone_number": "443-223-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 PETRIE AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101510",
            "telephone_number": "443-223-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIKER",
        "first_name": "BONNIE",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC011695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "OC011695",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

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