Active NPI
Bonnie P Whitebread, M.S. CCC-A
- Audiologist
- Wilkes Barre, PA
National Provider Identifier
1154358026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AT000262L
- Practice address
- Department of Veterans Affairs
1111 East End Blvd
Wilkes-Barre, PA 18711 - Phone
- (570) 824-3521
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AT000262L | PA | Primary |
Addresses
Primary practice location
Department of Veterans Affairs
1111 East End Blvd
Wilkes-Barre, PA 18711
Mailing address
455 Whitebread Lane
Sugarloaf, PA 18249
Phone (570) 788-2394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT000262L | PA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1154358026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 WHITEBREAD LANE",
"city": "SUGARLOAF",
"state": "PA",
"postal_code": "18249",
"telephone_number": "570-788-2394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DEPARTMENT OF VETERANS AFFAIRS",
"address_2": "1111 EAST END BLVD",
"city": "WILKES-BARRE",
"state": "PA",
"postal_code": "18711",
"telephone_number": "570-824-3521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEBREAD",
"first_name": "BONNIE",
"middle_name": "P",
"credential": "M.S. CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "PA",
"license": "AT000262L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.