Individual provider Active NPI

John Limb Bonner, L.C.S.W.

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1053575332
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
70035343501 Issued in UT
Practice address
150 S 600 E Ste 6B
Salt Lake City, UT 84102-1961
Phone
(801) 830-1592
Fax
(801) 953-0271
NPI assigned
Jul 15, 2008
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 70035343501 UT Primary

Addresses

Primary practice location

150 S 600 E Ste 6B
Salt Lake City, UT 84102-1961

Mailing address

115 S 1100 E Unit 510
Salt Lake City, UT 84102-1538
Phone (801) 830-1592

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

LicenseStateTypeSpecialty
70035343501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1053575332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 1100 E UNIT 510",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021538",
            "telephone_number": "801-830-1592",
            "fax_number": "801-953-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 600 E STE 6B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021961",
            "telephone_number": "801-830-1592",
            "fax_number": "801-953-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "JOHN",
        "middle_name": "LIMB",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "70035343501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.