Katelyn Jae Boone

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

28959 Issued in FL

Practice address

4217 SW 61St Ave
Davie, FL 33314-3614

Phone

(972) 977-8489

NPI assigned

Nov 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1912475005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 SW 61ST AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143614",
            "telephone_number": "972-977-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 SW 61ST AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143614",
            "telephone_number": "972-977-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KATELYN",
        "middle_name": "JAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "28959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Bonilla
• Rosanna Bonilla
• Brianna Yogita Boodhoo
• Janelle M Booker, M.S., BCBA
• Jonathan Keith Boone
• Jessica Booth
• Nislievy M Borges Tortolo
• Deanna Born, O.D.
• Joseph A Bornstein, MSN, APRN, FNP-BC
• Griselle Borrero

• Physical Therapy Assistant in Davie, FL
• Providers in Davie, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.