Shane Harold Bonella, M. COUN., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C2795 Issued in OR

Practice address

1215 SW G St
Grants Pass, OR 97526-2544

Phone

(541) 476-2373

Fax

(541) 955-7444

NPI assigned

Sep 30, 2010

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Options for Southern OregonGroup PAC ID 0941202006, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Options for Southern Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grants Pass, OR
  • NPI 1558366492
  Medicare reassignment Care Compare group NPD
• Options for Southern Oregon

  • Primary Care Clinic/Center
  • Grants Pass, OR
  • NPI 1952708422
  NPD

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1255640835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 HARBECK RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275605",
            "telephone_number": "541-476-2373",
            "fax_number": "541-955-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373",
            "fax_number": "541-955-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONELLA",
        "first_name": "SHANE",
        "middle_name": "HAROLD",
        "name_prefix": "Mr.",
        "credential": "M. COUN., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Luques Boldt, M.S.
• Nikki Marie Boles, LMT
• Kayla Rose Bomben, DPT
• Alexander Erino Bonato, MD
• Jaclyn Bondhus, PA-C
• John Adam Bonk, MD
• Nicole Booker
• Irene Francis Booth
• David Borota, DDS
• Pamela Borreson, LCSW

• Professional Counselor in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.