Individual provider Active NPI

Leonor NMN Bonnet-Engebretson, M.D.

  • Prison Health Clinic/Center
  • Atlanta, GA
National Provider Identifier
1023227394
Registry record updated Mar 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
License
9760 Issued in PR
Practice address
3212 Walnut RDG
Atlanta, GA 30349-8745
Phone
(770) 964-2216
Fax
(770) 964-3783
NPI assigned
May 22, 2007
Last updated
Mar 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X 9760 PR Primary

Addresses

Primary practice location

3212 Walnut RDG
Atlanta, GA 30349-8745

Mailing address

3212 Walnut RDG
Atlanta, GA 30349-8745
Phone (770) 964-2216

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9760PRMDPrison Health Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206835200000",
    "number": "1023227394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 WALNUT RDG",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303498745",
            "telephone_number": "770-964-2216",
            "fax_number": "770-964-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 WALNUT RDG",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303498745",
            "telephone_number": "770-964-2216",
            "fax_number": "770-964-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNET-ENGEBRETSON",
        "first_name": "LEONOR",
        "middle_name": "NMN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "PR",
            "license": "9760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2008; 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.