Holly Lyn Bonner, MPH, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

510 Butler Ave
Martinsburg, WV 25405-9990

Phone

(304) 263-0811

NPI assigned

Oct 12, 2017

Sex

Female

Sole proprietor

No

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

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in WV

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 21, 2024.

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1083125488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11281 WEATHERSTONE DR",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172688837",
            "telephone_number": "301-697-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "HOLLY",
        "middle_name": "LYN",
        "credential": "MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Bohrer
• Sarah Bohrer
• Adrian Bolton
• James G Bombino, D.C.
• William W Bonifant, DDS
• Julie Beth Bosley, LPC, CRCC
• Dovie Boswell
• Robert E Bowen, M.D.
• Karen Ann Bowerman, PA-C
• Bowers Mobility Sales & Repair

• All providers in Martinsburg, WV
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.