Active NPI
Alexandra Bonovitch, DNP
- Nurse Practitioner
- Longs, SC
National Provider Identifier
1093407694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 27618
- Practice address
- 2058 Borgata Loop
Longs, SC 29568-5756 - Phone
- (845) 522-7267
- NPI assigned
- May 22, 2023
- Last updated
- Jul 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 27618 | SC | Primary |
| General Practice Registered Nurse | 163WG0000X | 247546 | SC |
Addresses
Primary practice location
2058 Borgata Loop
Longs, SC 29568-5756
Mailing address
2058 Borgata Loop
Longs, SC 29568-5756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 247546 | SC | MD | General Practice Registered Nurse |
| 27618 | SC | MD | Nurse Practitioner |
Interoperability endpoints
- ms_abonovit@landmarkhealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1093407694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2058 BORGATA LOOP",
"city": "LONGS",
"state": "SC",
"postal_code": "295685756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2058 BORGATA LOOP",
"city": "LONGS",
"state": "SC",
"postal_code": "295685756",
"telephone_number": "845-522-7267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONOVITCH",
"first_name": "ALEXANDRA",
"credential": "DNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "27618",
"primary": true
},
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "SC",
"license": "247546",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longs, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.