Bonzer Medical, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BONZER MEDICAL, LLC

Doing business as

Bonzer Medical, LLC

Practice address

4423 S County Road 125 E
Greencastle, IN 46135-9237

Phone

(765) 653-8453

Fax

(765) 653-8493

NPI assigned

Apr 29, 2020

Last updated

Apr 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charlotte Louise Cramer, OFFICE MANANGER

Title

Office Manager

Phone

(765) 653-8453

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bonzer Medical, LLC Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1083235188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 S COUNTY ROAD 125 E",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461359237",
            "telephone_number": "765-653-8453",
            "fax_number": "765-653-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 S COUNTY ROAD 125 E",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461359237",
            "telephone_number": "765-653-8453",
            "fax_number": "765-653-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONZER MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "CRAMER",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "765-653-8453",
        "authorized_official_credential": "OFFICE MANANGER"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200521550",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02002904A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GREENCASTLE",
            "affiliation": "N",
            "address_1": "4423 S County Road 125 E",
            "city": "Greencastle",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461359237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bonzer Medical, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Greencastle, IN
• Providers in Greencastle, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.