Active NPI
Nancy Bonner
- Allergy Physician
- Marietta, GA
National Provider Identifier
1003369083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- GA
- Practice address
- 2150 Northwest Pkwy SE
Suite a
Marietta, GA 30067-9305 - Phone
- (888) 816-7047
- Fax
- (888) 840-1265
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | GA | GA | |
| Allergy Physician | 207KA0200X | GA | GA | Primary |
Addresses
Primary practice location
2150 Northwest Pkwy SE
Suite a
Marietta, GA 30067-9305
Mailing address
2150 Northwest Pkwy SE
Suite a
Marietta, GA 30067-9305
Phone (888) 816-7047
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA | GA | MD | Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1003369083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 NORTHWEST PKWY SE",
"address_2": "SUITE A",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300679305",
"telephone_number": "888-816-7047",
"fax_number": "888-840-1265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 NORTHWEST PKWY SE",
"address_2": "SUITE A",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300679305",
"telephone_number": "888-816-7047",
"fax_number": "888-840-1265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "NANCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "GA",
"license": "GA",
"primary": false
},
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "GA",
"license": "GA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.