Active NPI
Bonnie Jo Bayne, MD
- Family Medicine Physician
- Ann Arbor, MI
National Provider Identifier
1053422063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301062583
- Practice address
- 207 Fletcher
Ann Arbor, MI 48109-1050 - Phone
- (734) 764-8330
- Fax
- (734) 647-3074
- NPI assigned
- Aug 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301062583 | MI | Primary |
Addresses
Primary practice location
207 Fletcher
Ann Arbor, MI 48109-1050
Mailing address
207 Fletcher
Ann Arbor, MI 48109-1050
Phone (734) 764-8330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0808134271 | Other | MI | BCBS |
| C1921 | Other | MI | MCARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301062583 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053422063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 FLETCHER",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091050",
"telephone_number": "734-764-8330",
"fax_number": "734-647-3074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 FLETCHER",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091050",
"telephone_number": "734-764-8330",
"fax_number": "734-647-3074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYNE",
"first_name": "BONNIE",
"middle_name": "JO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301062583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0808134271",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE",
"identifier": "C1921",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.