Avery L Bonnema, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61061445 Issued in WA

Practice address

3009 S Grand Blvd
Spokane, WA 99203-2559

Phone

(509) 868-0849

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

University of Vermont College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake City Physical Therapy P aGroup PAC ID 3678465234, 13 clinicians

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.

• Lake City Physical Therapy P a

  • Physical Therapist
  • Spokane, WA
  • NPI 1588810659
  Medicare reassignment Care Compare group NPD
• Forty Six & Two, LLC

  • Physical Therapy Clinic/Center
  • Spokane, WA
  • NPI 1659627974
  Medicare reassignment NPD
• Advanced Physical Therapy Inc

  • Physical Therapist
  • Anchorage, AK
  • NPI 1437214459
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1164034393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032559",
            "telephone_number": "509-868-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032559",
            "telephone_number": "509-868-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEMA",
        "first_name": "AVERY",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61061445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeric-Kai Dasalla Bongolan
• Susan E Bonnand, PTA
• Laura A Bonneau, MD
• Robert Allen Bonneau, MD
• Cliff Bonnell-Jones, DPT
• Kimi Danielle Bonner
• Kyra Lynne Bonnett
• Bonnie Peterson
• Daniel R Bonogofski, REG. PHARMACIST
• Jaclyn Lynette Bonser, PHARMACY TECHNICIAN

• Physical Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.