Individual provider Active NPI

Harry Joseph Bonnaire, M.D.

  • Family Medicine Physician
  • Madison, TN
National Provider Identifier
1083609481
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD20429 Issued in TN
Practice address
607 W Due West Ave Ste 102
Madison, TN 37115-4420
Phone
(615) 868-2229
Fax
(615) 868-2432
NPI assigned
Sep 13, 2005
Last updated
Nov 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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 MD20429 TN Primary

Addresses

Primary practice location

607 W Due West Ave Ste 102
Madison, TN 37115-4420

Mailing address

601 NW Atlantic St
Tullahoma, TN 37388-3536
Phone (931) 393-5112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000557 TN Practitioner - Family Practice 3678472297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

607 W Due W Ave
Madison, TN 37115-4420
Phone (615) 868-2229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20429TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Due West Family Healthcare Inc Family Medicine CurrentSince Apr 23, 2004 Accepting new patients
Hopewell Medical Past Accepting new patients
Lung Consultants PLLC Past Accepting new patients
G.B. Medical Assoicates, Inc. Family Medicine PastSince Feb 15, 2006 Accepting new patients
Medical Necessities, Inc Past Accepting new patients
Agapee Surgical Associates Inc. Past Accepting new patients
Lebanon Health Care Center Family Medicine Past Accepting new patients

Locations

607 W Due West Ave
Ste 102
Madison, TN 37115
Phone (615) 868-2229

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1083609481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NW ATLANTIC ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883536",
            "telephone_number": "931-393-5112",
            "fax_number": "931-393-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE STE 102",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154420",
            "telephone_number": "615-868-2229",
            "fax_number": "615-868-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNAIRE",
        "first_name": "HARRY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD20429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

Verify at the official NPI Registry.