Bonnie Johng Nicklas, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36 002263 Issued in OH

Practice address

10701 East Blvd
Cleveland, OH 44106-1702

Phone

(216) 791-3800

Fax

(216) 421-3038

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Bonnie Johng Nicklas Professional name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083785208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7816 DORVER AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441055842",
            "telephone_number": "216-441-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800",
            "fax_number": "216-421-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLAS",
        "first_name": "BONNIE",
        "middle_name": "JOHNG",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36   002263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "NICKLAS",
            "middle_name": "JOHNG",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bradford A Nickel
• Travis J Nickels, MD
• Kyemberlyn S Nickens, NP
• Deanna Michelle Nickerson, AU.D.
• Ritann Nickerson
• Kathrin Nicolacakis, MD
• Diane G Nicolay, PA-C
• Marisa Brianne Nicoll, CNP
• Nicole Nicolosi, DPM
• Alexandros W Nicolozakes, MD

• Podiatrist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.