Jacob Andrew Bonner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11474 Issued in TX

Practice address

201 N Collegiate Dr
#900
Paris, TX 75460-1494

Phone

(515) 447-5256

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1164555009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N COLLEGIATE DR",
            "address_2": "#900",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754601494",
            "telephone_number": "515-447-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N COLLEGIATE DR",
            "address_2": "#900",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754601494",
            "telephone_number": "515-447-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06956",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "06956",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11474",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damilola Bodunrin
• Darquarius Bogan
• Emilee Paige Bolin
• Jeri Ann Bolton, AS,RRT,NPS,CPFT
• Jordan Bolton
• Ballard Ray Boren, DC
• Gleb G Bourianoff, MD
• Madeline Bowers
• Brandon del Toro DDS PLLC
• Alishia Diane Bratcher, APRN, NP-C

• All providers in Paris, TX
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.