Clinton Allen Bonn, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3882 Issued in MN

Practice address

508 W 4TH St
Madison, MN 56256-1426

Phone

(320) 598-3089

Fax

(320) 598-3089

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Madison Chiropractic Center PC

  • Health Service Clinic/Center
  • Madison, MN
  • NPI 1801120258

  MN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1104842426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W 4TH ST",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "562561426",
            "telephone_number": "320-598-3089",
            "fax_number": "320-598-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W 4TH ST",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "562561426",
            "telephone_number": "320-598-3089",
            "fax_number": "320-598-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONN",
        "first_name": "CLINTON",
        "middle_name": "ALLEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721157100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Boyens, RD
• Angela Louisia Elsner Brown, MT
• Kristi Carlson, PHARMD.
• Matthew Carmody, PT, DPT
• Centracare Medical Supply LLC

• All providers in Madison, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.