Active NPI
Bonnie Proulx, APRN
- Nurse Practitioner
- Manchester, NH
National Provider Identifier
1366499808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN276993
- Practice address
- 100 Hitchcock Way
Manchester, NH 03104-4125 - Phone
- (603) 695-2500
- NPI assigned
- May 30, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 00000-01 | NH | |
| Nurse Practitioner | 363L00000X | RN276993 | GA | Primary |
Addresses
Primary practice location
100 Hitchcock Way
Manchester, NH 03104-4125
Mailing address
100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30010535 | Medicaid | NH |
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 |
|---|---|---|---|
| RN276993 | GA | MD | Nurse Practitioner |
| 00000-01 | NH | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CH DHC Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Concord, NH
- NPI 1083654941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600646400000",
"number": "1366499808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HITCHCOCK WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044125",
"telephone_number": "603-695-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HITCHCOCK WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044125",
"telephone_number": "603-695-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROULX",
"first_name": "BONNIE",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-30",
"last_updated": "2020-09-21",
"certification_date": "2020-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NH",
"license": "00000-01",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN276993",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30010535",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
- Monique Marie Colleen Prince, MSW, LICSW
- Lauren Marie Priolo, M.D.
- Procare Home Health & Senior Services LLC
- Annmarie Nancy Proksa, PTA
- Promise Integrated Care LLC
- Crystal Ann Proulx, MSRD, LD, CNSD
- Norman Henry Proulx, D.D.S.
- Danielle Ann Provencal
- Jeremy M Provencher, PA-C
- Robert F. Provencher Jr., DDS
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.