Individual provider Active NPI

Katie Jane Bonar, CRNP

  • Family Medicine Physician
  • Decatur, AL
National Provider Identifier
1083254320
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1-121641 Issued in AL
Practice address
1215 7TH St SE Ste 140
Decatur, AL 35601-3394
Phone
(256) 973-5400
NPI assigned
Jan 15, 2020
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1-121641 AL Primary

Addresses

Primary practice location

1215 7TH St SE Ste 140
Decatur, AL 35601-3394

Mailing address

1215 7TH St SE Ste 140
Decatur, AL 35601-3394
Phone (256) 973-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200324000955 AL Practitioner - Nurse Practitioner 0749618809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Morgan Primary CareGroup PAC ID 2860715521, 12 clinicians

Practice addresses (Care Compare)

1215 7TH St SE
Decatur, AL 35601-3304
Phone (256) 973-5400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Morgan Primary Care Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Priceville Primary Care Family Medicine Past Accepting new patients

Locations

1215 7th St SE
Decatur, AL 35601
Phone (256) 351-5400

1215 7th St SE
Ste 140
Decatur, AL 35601
Phone (256) 351-5400

301 Pine St NW
Ste A
Hartselle, AL 35640
Phone (256) 773-5469

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1083254320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 7TH ST SE STE 140",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013394",
            "telephone_number": "256-973-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 7TH ST SE STE 140",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013394",
            "telephone_number": "256-973-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAR",
        "first_name": "KATIE",
        "middle_name": "JANE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "1-121641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.