The Bonin Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

AP04429 Issued in LA

Legal business name

THE BONIN CLINIC LLC

Practice address

1215 Independence Blvd
1A
Zachary, LA 70791-7390

Phone

(225) 570-2010

Fax

(225) 570-8573

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Otto Joseph Bonin, NPNPI 1558368316

Title

Owner

Phone

(225) 570-2010

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Otto Joseph Bonin Jr., NP

  • Nurse Practitioner
  • Zachary, LA
  • NPI 1558368316
  Medicare reassignment Care Compare group NPD Authorized official
• Chelsey D Phillips, NP

  • Family Nurse Practitioner
  • Zachary, LA
  • NPI 1356833883
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1003280512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 INDEPENDENCE BLVD",
            "address_2": "1A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707917390",
            "telephone_number": "225-570-2010",
            "fax_number": "225-570-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 INDEPENDENCE BLVD",
            "address_2": "1A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707917390",
            "telephone_number": "225-570-2010",
            "fax_number": "225-570-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BONIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "BONIN",
        "authorized_official_first_name": "OTTO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-570-2010",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "AP04429",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Talbot Thompson
• Charles Allen Thompson, M.D.

• Primary Care Clinic/Center in Zachary, LA
• Providers in Zachary, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.