Bonetta Lou Coulter, APRN-CNS

Individual provider Active NPI Adult Health Clinical Nurse Specialist · Columbus, OH

NPI 1083257604 · NPPES record last updated Oct 27, 2019

Key facts

NPI
1083257604
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Clinical Nurse Specialist 364SA2200X
License
APRNCNS019419 (OH)
Practice address
1601 W Broad St
Columbus, OH 43222-1054
Phone
(614) 272-3115
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

Medicare Care Compare profile

Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Ohio Office of Budget and Management State Accounting (109 clinicians)

Practice addresses (Care Compare)

1601 W Broad St
Columbus, OH 43222-1087
Phone (614) 272-0509

Hospital & facility affiliations

  • Doctors Hospital Hospital · Columbus, OH · CCN 360152

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200918000423 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 1951729235 Reassigns benefits to 1 organization
Practice locations: Bucyrus, OH

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
APRNCNS019419OHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
Tiffin Developmental Center Current
since Aug 22, 2022
Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current
since Aug 22, 2022
Accepting new patients

Locations

1601 W Broad St
Columbus, OH 43222
Phone (614) 272-0509

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X APRNCNS019419 OH Yes

Addresses

Primary practice location

1601 W Broad St
Columbus, OH 43222-1054

Mailing address

566 E Kelso Rd
Columbus, OH 43202-2326
Phone (614) 268-7109

Other names

  • Bonnie L Coulter Other name

Electronic endpoints

TypeEndpointUseAffiliation
Other URL COLUMBUS Other

Other providers in Columbus, OH

All providers in Columbus, OH · Adult Health Clinical Nurse Specialist in Ohio

Sources for this page

Verify at the official NPI Registry.