Individual provider Active NPI

Bonnie Katrina Howley, DO

  • Family Medicine Physician
  • Farmington, MO
National Provider Identifier
1285795849
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9F07 Issued in MO
Practice address
504 Wynnfield LN
Farmington, MO 63640-7698
Phone
(573) 631-7833
NPI assigned
Dec 13, 2006
Last updated
Dec 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R9F07 MO Primary

Addresses

Primary practice location

504 Wynnfield LN
Farmington, MO 63640-7698

Mailing address

504 Wynnfield LN
Farmington, MO 63640-7698
Phone (573) 631-7833

Other identifiers 1

IdentifierTypeStateIssuer
242266104MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100827000854 MO Practitioner - Family Practice 3577687516 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri CurrentSince Dec 31, 1991 Accepting new patients
State of Missouri CurrentSince Dec 31, 1991 Accepting new patients

Locations

1010 W Columbia St
Farmington, MO 63640
Phone (573) 218-6792

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1285795849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 WYNNFIELD LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407698",
            "telephone_number": "573-631-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WYNNFIELD LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407698",
            "telephone_number": "573-631-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWLEY",
        "first_name": "BONNIE",
        "middle_name": "KATRINA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9F07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242266104",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.