Individual provider Active NPI

Natasha Bonner, D.C.

  • Chiropractor
  • Allen, TX
National Provider Identifier
1336467992
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11431 Issued in TX
Practice address
1108 Timberbend TRL
Allen, TX 75002-2949
Phone
(469) 422-0316
NPI assigned
May 6, 2010
Last updated
Jul 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11431 TX Primary

Addresses

Primary practice location

1108 Timberbend TRL
Allen, TX 75002-2949

Mailing address

515 W Main St
Ste 101
Allen, TX 75013-8020
Phone (214) 514-8274

Other names 1

  • Natasha Polivka Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000242 TX Practitioner - Chiropractic 9133379399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Natasha T Bonner DC PLLCGroup PAC ID 1153571310, 3 clinicians

Practice addresses (Care Compare)

515 W Main St
Suite 102 Allen Family Chiropractic
Allen, TX 75013-8021
Phone (972) 908-3322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11431TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Julie Reddell Gruben DC PLLC Chiropractor CurrentSince Nov 19, 2019 Accepting new patients

Locations

515 W Main St
Ste 101
Allen, TX 75013
Phone (972) 359-7911

515 W Main St
Ste 102
Allen, TX 75013
Phone (972) 747-5077

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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1336467992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W MAIN ST",
            "address_2": "STE 101",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138020",
            "telephone_number": "214-514-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 TIMBERBEND TRL",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750022949",
            "telephone_number": "469-422-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "NATASHA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "POLIVKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.