Active NPI
Bonnie J Summers, NP
- Nurse Practitioner
- Centreville, IL
National Provider Identifier
1184608986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209000301
- Practice address
- 6000 Bond Ave
Centreville, IL 62207-2328 - Phone
- (618) 332-2740
- Fax
- (618) 337-6039
- NPI assigned
- Dec 5, 2005
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209000301 | IL | Primary |
Addresses
Primary practice location
6000 Bond Ave
Centreville, IL 62207-2328
Mailing address
6000 Bond Ave
Centreville, IL 62207-2328
Phone (618) 332-2740
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APN209000301 | Other | IL | ADV PRACTICE NURSE ID |
| RN041-127414 | Other | IL | REGISTERED NURSE ID |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209000301 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1184608986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6000 BOND AVE",
"city": "CENTREVILLE",
"state": "IL",
"postal_code": "622072328",
"telephone_number": "618-332-2740",
"fax_number": "618-332-8755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 BOND AVE",
"city": "CENTREVILLE",
"state": "IL",
"postal_code": "622072328",
"telephone_number": "618-332-2740",
"fax_number": "618-337-6039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "BONNIE",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-05",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209000301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADV PRACTICE NURSE ID",
"identifier": "APN209000301",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE ID",
"identifier": "RN041-127414",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centreville, IL
- Southern Illinois Healthcare Foundation Inc
- Southern Illinois Healthcare Foundation, Inc
- Southern Illinois Healthcare Foundation, Inc.
- Amanda Michele Stahnke, PHARMD
- Birgit Sterzl, DIETICIAN
- Heather Surratt, D.D.S.
- Diana L Swanson, MSN, APRN, WHNP-BC
- Jami Szwargulski, RD, LD
- Tyler D Thurman, LCPC
- Transitional Center Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.