Active NPI
Bonita Klahn Vestal, M.D.
- Pediatric Hematology & Oncology Physician
- Boise, ID
National Provider Identifier
1245224377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- M-3713
- Practice address
- 1502 W Franklin St
Boise, ID 83702-4028 - Phone
- (208) 385-7868
- Fax
- (208) 344-3059
- NPI assigned
- Sep 5, 2005
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Pediatric Hematology & Oncology Physician | 2080P0207X | M-3713 | ID | Primary |
Addresses
Primary practice location
1502 W Franklin St
Boise, ID 83702-4028
Mailing address
1502 W Franklin St
Boise, ID 83702-4028
Phone (208) 385-7868
Other names 1
- Dr. Bonnie Vestal
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-3713 | ID | MD | Pediatric Hematology & Oncology Physician |
Interoperability endpoints
- https://api.platform.athenahealth.com/14835/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1245224377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 W FRANKLIN ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024028",
"telephone_number": "208-385-7868",
"fax_number": "208-344-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 W FRANKLIN ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024028",
"telephone_number": "208-385-7868",
"fax_number": "208-344-3059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VESTAL",
"first_name": "BONITA",
"middle_name": "KLAHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "ID",
"license": "M-3713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "VESTAL",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.