Angela M Bronestine, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056009307 Issued in IL

Practice address

55774 Mo-6
Edina, MO 63537

Phone

(660) 397-2282

NPI assigned

Jun 13, 2013

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Angela M King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962840777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SYCAMORE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623011639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55774 MO-6",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "63537",
            "telephone_number": "660-397-2282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Sycamore St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623011639",
            "country_code": "US",
            "telephone_number": "217-222-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONESTINE",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056009307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "KING",
            "middle_name": "M",
            "credential": "MOT, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Michelle Bosch, DMD
• Hannah Jo Braungardt, DO
• Robert Dale Collinge, DDS
• Hannah Katherine Dale
• Joyce C Delaney
• HRW, Inc. (The Blessing Center)
• HRW, Inc. (The Blessing Center)

• Occupational Therapist in Edina, MO
• Providers in Edina, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.