Active NPI
Joe Bonazza, RN
- Case Management Registered Nurse
- Charleston, WV
National Provider Identifier
1316553746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 73481
- Practice address
- 1508 Bigley Ave Ste a
Charleston, WV 25302-3904 - Phone
- (304) 935-1069
- NPI assigned
- Sep 21, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 73481 | WV | Primary |
Addresses
Primary practice location
1508 Bigley Ave Ste a
Charleston, WV 25302-3904
Mailing address
1508 Bigley Ave Ste a
Charleston, WV 25302-3904
Phone (304) 935-1069
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73481 | WV | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600646400000",
"number": "1316553746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 BIGLEY AVE STE A",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253023904",
"telephone_number": "304-935-1069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 BIGLEY AVE STE A",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253023904",
"telephone_number": "304-935-1069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONAZZA",
"first_name": "JOE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-21",
"last_updated": "2020-09-21",
"certification_date": "2020-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "WV",
"license": "73481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.