Shawn Patrick Bonilla, N.P.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

ROO68442 Issued in OK

Practice address

821 E Veterans Memorial Hwy
Blanchard, OK 73010-9215

Phone

(405) 659-5656

Fax

(405) 701-5421

NPI assigned

Oct 3, 2006

Last updated

Mar 24, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Healthcare StatGroup PAC ID 7012067762, 2 clinicians

Healthcare Stat of Newcastle LLCGroup PAC ID 2769760768, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthcare Stat

  • Primary Care Clinic/Center
  • Chickasha, OK
  • NPI 1609029644
  Medicare reassignment Care Compare group NPD Authorized official
• Healthcare Stat of Newcastle LLC

  dba Healthcare Stat of Newcastle

  • Family Nurse Practitioner
  • Newcastle, OK
  • NPI 1346796604
  Medicare reassignment Care Compare group NPD Authorized official
• Healthcare Stat

  • Urgent Care Clinic/Center
  • Blanchard, OK
  • NPI 1669906806
  NPD Authorized official
• Allergy & Respiratory Clinic of Southern Ok LLC

  • Clinic/Center
  • Blanchard, OK
  • NPI 1437433885
  NPD (past) Authorized official
• Healthcare Stat of Lindsay LLC

  • Family Nurse Practitioner
  • Lindsay, OK
  • NPI 1447765086
  Authorized official Same address or phone
• Complete Family Wellness and Urgent Care

  • Primary Care Nurse Practitioner
  • Lindsay, OK
  • NPI 1679153548
  NPD
• Kingston Pharmacy LLC

  • Community/Retail Pharmacy
  • Kingston, OK
  • NPI 1033191234
  NPD (past)
• Lightstar Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Shawnee, OK
  • NPI 1396736872
  NPD (past)
• Norstar Emergency Physicians

  • Emergency Medical Services (Emergency Medicine) Physician
  • Norman, OK
  • NPI 1093709537
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1134213978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5908",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730705908",
            "telephone_number": "405-659-5656",
            "fax_number": "405-701-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E VETERANS MEMORIAL HWY",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730109215",
            "telephone_number": "405-659-5656",
            "fax_number": "405-701-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "ROO68442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200226680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blanchard Drug & Gift Inc (Blanchard Drug)
• Blanchard Family Medicine
• Blanchard Molar (Contemporary Family Dentistry)
• Bloomquist Foot and Ankle PLLC
• Misty Marie Bogle, M.D.
• Susan Diane Branam, LADC, LCSW
• Brant D. Spencer D.C. P.C.
• Cassie Jo Brown, OTR/L
• Tyler Adam Brown
• Brooklyne N. Brumley

• Acute Care Nurse Practitioner in Blanchard, OK
• Providers in Blanchard, OK by specialty
• Acute Care Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.
• 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.