Active NPI
Kenneth Bonser, RPH
- Pharmacist
- Ukiah, CA
National Provider Identifier
1376310243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88878
- Practice address
- 653 S State St
Ukiah, CA 95482-4912 - Phone
- (707) 467-2712
- NPI assigned
- Dec 11, 2023
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 88878 | CA | Primary |
Addresses
Primary practice location
653 S State St
Ukiah, CA 95482-4912
Mailing address
PO Box 2012
Ukiah, CA 95482-2200
Other practice location 1
660 S Main St
Fort Bragg, CA 95437-5108
Phone (707) 964-4058
Other practice location 2
1115 Vine St
Healdsburg, CA 95448-4831
Phone (707) 431-0128
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 Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88878 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Healdsburg, CA
- NPI 1306882923
-
- Community/Retail Pharmacy
- Ukiah, CA
- NPI 1346279361
-
- Community/Retail Pharmacy
- Fort Bragg, CA
- NPI 1619913498
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1376310243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2012",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 S STATE ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824912",
"telephone_number": "707-467-2712"
}
],
"practiceLocations": [
{
"address_1": "660 S Main St",
"address_purpose": "LOCATION",
"city": "Fort Bragg",
"state": "CA",
"postal_code": "954375108",
"country_code": "US",
"telephone_number": "707-964-4058",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1115 Vine St",
"address_purpose": "LOCATION",
"city": "Healdsburg",
"state": "CA",
"postal_code": "954484831",
"country_code": "US",
"telephone_number": "707-431-0128",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BONSER",
"first_name": "KENNETH",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-11",
"last_updated": "2024-06-26",
"certification_date": "2024-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.