Bonnie A Degrave, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

1300 Egg Harbor Rd Ste 152
Sturgeon Bay, WI 54235-1248

Phone

(920) 746-0410

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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.

• Door County Memorial Hospital

  • Critical Access Hospital
  • Sturgeon Bay, WI
  • NPI 1093743874
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

Practice roles

• Bonnie A Jones Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2024.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1215045893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 EGG HARBOR RD STE 152",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351248",
            "telephone_number": "920-746-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAVE",
        "first_name": "BONNIE",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40388200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "JONES",
            "middle_name": "A",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven S. Davis, M.D.
• Connor Allen Daws, OTD, OTR/L
• DC Medical Transport
• Jennifer Marie Dean, DPT
• Annelise Deboer, DPT
• Linda Dekeyser
• Dorene E. Dempster, M.D.
• Kristine Demuth, PTA
• Heidi Derbick, FNP
• Luann M Desotelle

• All providers in Sturgeon Bay, WI
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.