Active NPI
Daisy Bonilla
- Social Worker
- Rogers, AR
National Provider Identifier
1326536822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8569-M
- Practice address
- 1200 W Walnut St Ste 3100
Rogers, AR 72756-3524 - Phone
- (479) 631-9996
- NPI assigned
- Apr 30, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 8569-M | AR | Primary |
Addresses
Primary practice location
1200 W Walnut St Ste 3100
Rogers, AR 72756-3524
Mailing address
118 N 2ND St Ste 200
Saint Charles, MO 63301-2894
Phone (636) 224-1210
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8569-M | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1326536822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 N 2ND ST STE 200",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012894",
"telephone_number": "636-224-1210",
"fax_number": "636-946-0991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W WALNUT ST STE 3100",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563524",
"telephone_number": "479-631-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONILLA",
"first_name": "DAISY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "8569-M",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.