Harry Joseph Bonnaire, M.D.
Individual provider Active NPI Family Medicine Physician · Madison, TN
NPI 1083609481 · NPPES record last updated Nov 17, 2015
Key facts
- NPI
- 1083609481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD20429 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040102000557 | TN | Practitioner - Family Practice | 3678472297 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20429 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Due West Family Healthcare Inc | Family Medicine | Current |
Accepting new patients |
| G.B. Medical Assoicates, Inc. | Family Medicine | Past |
Accepting new patients |
| Agapee Surgical Associates Inc. | Past | Accepting new patients | |
| Hopewell Medical | Past | Accepting new patients | |
| Medical Necessities, Inc | Past | Accepting new patients | |
| Lung Consultants PLLC | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD20429 | TN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083609481 | Other | TN | NPI |
| 3000061 | Other | TN | TULLAHOMA MEDICARE |
| 3000061 | Medicaid | TN | |
| 3807797 | Medicaid | TN | |
| 3807797 | Other | TN | MEDICARE OTHER |
Other providers in Madison, TN
- Timothy M Blair
- Amanda Lynn Blassl
- Brooks Taylor Blaxton
- Andrew Steven Blaylock
- Jacob Blood
- Judy Book
- Carol Marie Boone
- Ashley Lynne Boswell
- Laura Boswell
- Anthony L Bowers Sr.
All providers in Madison, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.