One Bread One Body MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ONE BREAD ONE BODY MD LLC

Practice address

513 Central Ave N Ste 1
Faribault, MN 55021-4322

Phone

(507) 301-7602

Fax

(507) 301-7602

NPI assigned

May 12, 2025

Organization subpart

No

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

Authorized official

Name

Wendy Bongers, MDNPI 1306803135

Title

Practice Owner

Phone

(507) 301-7602

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wendy M Bongers, MD

  • Family Medicine Physician
  • Woodbury, MN
  • NPI 1306803135
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1083404966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 CENTRAL AVE N STE 1",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214322",
            "telephone_number": "507-301-7602",
            "fax_number": "507-301-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 CENTRAL AVE N STE 1",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214322",
            "telephone_number": "507-301-7602",
            "fax_number": "507-301-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE BREAD ONE BODY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "BONGERS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "507-301-7602",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Lavern Ohlsen
• Joseph Oliver
• Bashir Omar I
• Bilal Omar
• Hassan Omar
• Habso Osman
• Zainab Abdullahi Osman
• Our Circle of Friends
• Cristian Overland
• Kristine Marie Owen-Katona, LADC

• Dermatology Physician in Faribault, MN
• Providers in Faribault, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.