Clarence Bonoan Amayun, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

01041643A Issued in IN

Practice address

3611 S Reed Rd
Suite 106
Kokomo, IN 46902-3828

Phone

(765) 453-8001

Fax

(765) 453-8002

NPI assigned

Jan 25, 2006

Last updated

May 4, 2009By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Heartland Cardiologypc

  • Medical Specialty Clinic/Center
  • Kokomo, IN
  • NPI 1962645861
  Authorized official Same address or phone
• Ekg Interpretation Professionsals

  • Cardiovascular Disease Physician
  • Kokomo, IN
  • NPI 1912009119
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1184694895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 E 100 N",
            "address_2": "SUITE106",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469018319",
            "telephone_number": "765-453-8585",
            "fax_number": "765-453-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S REED RD",
            "address_2": "SUITE 106",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023828",
            "telephone_number": "765-453-8001",
            "fax_number": "765-453-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYUN",
        "first_name": "CLARENCE",
        "middle_name": "BONOAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01041643A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abeer Said Alqaisi, MD
• Melissa Alter
• Courtney Altherr
• Adylynn Altman
• Altra Home Health, LLC
• Nathan Clarence Amayun
• Amedisys Hospice, LLC (Amedisys Hospice)
• American Health Network of Indiana, LLC
• American Health Network of Indiana, LLC
• American Health Network of Indiana, LLC

• Specialist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; 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.