Bon Nola, M.D. , LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0424718 Issued in KS

Legal business name

BON NOLA, M.D. , LLC

Practice address

804 S Oliver Ave
Wichita, KS 67218-2329

Phone

(316) 689-6004

Fax

(316) 613-2934

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Bounsavath Nola, M.D.NPI 1356336515

Title

Owner

Phone

(316) 689-6004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bounsavath Nola, MD

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1356336515
  Medicare reassignment NPD Authorized official
• Reine Nola, D.P.T.

  • Physical Therapist
  • Wichita, KS
  • NPI 1053733436
  NPD (past)

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1275715534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 S BLUFFVIEW DR",
            "address_2": "S-116",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183039",
            "telephone_number": "316-689-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S OLIVER AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182329",
            "telephone_number": "316-689-6004",
            "fax_number": "316-613-2934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 S Bluffview Dr",
            "address_2": "S-116",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672183039",
            "country_code": "US",
            "telephone_number": "316-689-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BON NOLA, M.D. , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "NOLA",
        "authorized_official_first_name": "BOUNSAVATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-689-6004",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0424718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Bolt, MD
• Karen Ann Bombardier, MA, CCC-SLP
• Nick Bombardier
• Richard Bomgardner, ATC
• Sarah Partridge Bommarito, OTR/L
• Alisha Bond
• Andrea Bond, PHARMD
• Jack A Bond, RPH
• James Richard Bond, DO
• Joshua S Bond

• Internal Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.