Individual provider Active NPI

Gloria A Bonamy, RN

  • Registered Nurse
  • Farmington Hills, MI
National Provider Identifier
1386930840
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704180761 Issued in MI
Practice address
20853 Farmington Rd
Farmington Hills, MI 48336-5183
Phone
(248) 476-9091
Fax
(248) 476-1011
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704180761 MI Primary

Addresses

Primary practice location

20853 Farmington Rd
Farmington Hills, MI 48336-5183

Mailing address

20853 Farmington Rd
Farmington Hillls, MI 48322-5183
Phone (248) 476-9091

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 Nurse

State licenses

LicenseStateTypeSpecialty
4704180761MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Excellacare 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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1386930840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20853 FARMINGTON RD",
            "city": "FARMINGTON HILLLS",
            "state": "MI",
            "postal_code": "483225183",
            "telephone_number": "248-476-9091",
            "fax_number": "248-476-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20853 FARMINGTON RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365183",
            "telephone_number": "248-476-9091",
            "fax_number": "248-476-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAMY",
        "first_name": "GLORIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704180761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.