Bonaventura Reproductive Medicine

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

Legal business name

BONAVENTURA REPRODUCTIVE MEDICINE

Practice address

11725 N Illinois St
Ste 345
Carmel, IN 46032-3008

Phone

(317) 814-4570

Fax

(317) 814-4517

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Leo Bonaventura, MD

Title

Owner

Phone

(317) 814-4570

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1245442177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11725 N ILLINOIS ST",
            "address_2": "STE 345",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323008",
            "telephone_number": "317-814-4570",
            "fax_number": "317-814-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 N ILLINOIS ST",
            "address_2": "STE 345",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323008",
            "telephone_number": "317-814-4570",
            "fax_number": "317-814-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONAVENTURA REPRODUCTIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "BONAVENTURA",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-814-4570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000328110",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000580355",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Bolden, MSOT/L
• Stephen Gerard Bolger, MSW
• Kristine J. Bolin, M.D.
• Arya L Bolla
• Ellisa Anne Bolton, NP
• Bonita Streetman, LLC
• Bonk Ventures LLC
• Kristina Bonnet
• Anna Bontrager
• Barrett Steven Boody, M.D.

• Reproductive Endocrinology Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Reproductive Endocrinology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.