Individual provider Active NPI

Lara P Bonner Millar, MD

  • Radiation Oncology Physician
  • Norfolk, VA
National Provider Identifier
1336354745
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101251893 Issued in VA
Practice address
600 Gresham Dr
Radiation Oncology
Norfolk, VA 23507-1904
Phone
(757) 388-3483
Fax
(757) 627-0334
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 0101251893 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Radiation Oncology
Norfolk, VA 23507-1904

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 388-3483

Other practice location 1

204800 Market Street
Onancoke, VA 23417-2341
Phone (757) 302-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120612000566 VA Practitioner - Radiation Oncology 0244494789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Maryland School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

20480 Market St
Onancock, VA 23417-4309
Phone (757) 302-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101251893VAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services, Inc. Radiation Oncology CurrentSince Nov 27, 2023 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation Radiation Oncology CurrentSince Jul 16, 2012 Accepting new patients
Riverside Physician Services Inc CurrentSince Nov 27, 2023 Accepting new patients

Locations

3000 Coliseum Dr
Ste 104
Hampton, VA 23666
Phone (757) 827-9400

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

20480 Market St
Onancock, VA 23417
Phone (757) 302-2100

1950 Glenn Mitchell Dr
Ste 102
Virginia Beach, VA 23456
Phone (757) 368-0437

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

Interoperability endpoints

  • Direct secure messaging: voaprincessanneradonc@directaddress.net
  • Direct secure messaging: drlbonnermillar@directaddress.net

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1336354745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-388-3483",
            "fax_number": "757-627-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "address_2": "RADIATION ONCOLOGY",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3483",
            "fax_number": "757-627-0334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204800 Market Street",
            "address_purpose": "LOCATION",
            "city": "Onancoke",
            "state": "VA",
            "postal_code": "234172341",
            "country_code": "US",
            "telephone_number": "757-302-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNER MILLAR",
        "first_name": "LARA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101251893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.