Bonny Anne Wallace

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

167 Aipuni St
Hilo, HI 96720-1803

Phone

(808) 959-5855

NPI assigned

Oct 7, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1043972953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 KINOOLE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205245",
            "telephone_number": "808-959-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 AIPUNI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201803",
            "telephone_number": "808-959-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BONNY ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Steve Walicki
• Makanihoolaeokealoha Eliu Walker
• Warren Wailani Walker, MSW
• Wallace F. Chong, DDS, Inc
• Walmart Inc.
• Walmart, Inc.
• Erin Walters
• Henaninooekawahineui Wandasan
• Angela Wang, MA

• Community Health Worker in Hilo, HI
• Providers in Hilo, HI by specialty
• Community Health Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.