Individual provider Active NPI

Michelle Nicole Bonnet, MD

  • Psychiatry Physician
  • Moraine, OH
National Provider Identifier
1215467261
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.142479 Issued in OH
Practice address
5350 Lamme Rd
Moraine, OH 45439-3215
Phone
(937) 534-4620
Fax
(937) 522-8799
NPI assigned
Jun 13, 2017
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.142479 OH Primary

Addresses

Primary practice location

5350 Lamme Rd
Moraine, OH 45439-3215

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbonnet571016@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20210610001319 OH Practitioner - Psychiatry 9436559598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wright State University Boonshoft School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3550 Lamme Rd
Dayton, OH 45439-3215
Phone (937) 534-4620

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

5348 Lamme Rd
Moraine, OH 45439-3215
Phone (937) 534-4651

5350 Lamme Rd
Moraine, OH 45439-3215
Phone (937) 534-4620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3920

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 762-1306

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

5348 Lamme Rd
Moraine, OH 45439
Phone (937) 534-4651

5350 Lamme Rd
Moraine, OH 45439
Phone (937) 534-4632

Interoperability endpoints

  • Direct secure messaging: mbonnet571016@direct.ketteringhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1215467261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 LAMME RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454393215",
            "telephone_number": "937-534-4620",
            "fax_number": "937-522-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNET",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.142479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbonnet571016@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "5350 Lamme Rd",
            "city": "Moraine",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454393215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "5350 Lamme Rd",
            "city": "Moraine",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454393215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.