Active NPI
Harris L Bonnette, M.D.
- Neurology Physician
- Fort Myers, FL
National Provider Identifier
1114928009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 01085010A
- Practice address
- 13782 Plantation Rd Ste 201
Fort Myers, FL 33912-4462 - Phone
- (239) 343-1290
- Fax
- (239) 343-4008
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME0029202 | FL | |
| Neurology Physician | 2084N0400X | 01085010A | IN | Primary |
Addresses
Primary practice location
13782 Plantation Rd Ste 201
Fort Myers, FL 33912-4462
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1449
Other practice location 1
11104 Parkview Circle Dr Ste 110
Fort Wayne, IN 46845-1673
Phone (260) 425-6780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037453900 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0029202 | FL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Radiology Consultants P a | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Fort Myers, FL
- NPI 1518911668
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1114928009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-424-1449",
"fax_number": "239-424-1423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13782 PLANTATION RD STE 201",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124462",
"telephone_number": "239-343-1290",
"fax_number": "239-343-4008"
}
],
"practiceLocations": [
{
"address_1": "11104 Parkview Circle Dr Ste 110",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468451673",
"country_code": "US",
"telephone_number": "260-425-6780",
"fax_number": "260-425-6789",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BONNETTE",
"first_name": "HARRIS",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME0029202",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "01085010A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037453900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.