Individual provider Active NPI

Bonnie J O'Daye

  • Family Nurse Practitioner
  • Carson City, NV
National Provider Identifier
1053095794
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
865914 Issued in NV
Practice address
1385 Vista LN
Carson City, NV 89703-4643
Phone
(775) 884-4567
NPI assigned
Jun 13, 2023
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 865914 NV Primary

Addresses

Primary practice location

1385 Vista LN
Carson City, NV 89703-4643

Mailing address

1385 Vista LN
Carson City, NV 89703-4643
Phone (775) 884-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801003747 NV Practitioner - Nurse Practitioner 6305207770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
85.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. Nurse Practitioner CurrentSince Jun 3, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

8329 W Sunset Rd
Ste 100
Las Vegas, NV 89113

Interoperability endpoints

  • Direct secure messaging: bodaye16569@direct-prd.molinahealthcare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1053095794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 VISTA LN",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034643",
            "telephone_number": "775-884-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 VISTA LN",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034643",
            "telephone_number": "775-884-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DAYE",
        "first_name": "BONNIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "865914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.