Individual provider Active NPI

Nikki Sue Bonilla King, FNP

  • Nurse Practitioner
  • Great Falls, MT
National Provider Identifier
1396500245
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NUR-APRN-LIC-234184 Issued in MT
Practice address
1301 11TH Ave S Ste 6
Great Falls, MT 59405-4654
Phone
(406) 868-7342
NPI assigned
Feb 20, 2024
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NUR-APRN-LIC-234184 MT Primary

Addresses

Primary practice location

1301 11TH Ave S Ste 6
Great Falls, MT 59405-4654

Mailing address

1708 2ND Ave N
Great Falls, MT 59401-3226
Phone (406) 868-7342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503002000 MT Practitioner - Nurse Practitioner 9638519945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

1301 11TH Ave S
Suite 6
Great Falls, MT 59405-4654
Phone (406) 455-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-234184MTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc CurrentSince Apr 23, 2024 Accepting new patients
Benefis Hospitals, Inc. CurrentSince Apr 23, 2024 Accepting new patients
Benefis Hospitals, Inc. Past Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1301 11th Ave S
Ste 6
Great Falls, MT 59405
Phone (406) 455-2777

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1396500245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 2ND AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013226",
            "telephone_number": "406-868-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 11TH AVE S STE 6",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054654",
            "telephone_number": "406-868-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA KING",
        "first_name": "NIKKI",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "NUR-APRN-LIC-234184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.