Tommy Bohannan

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

11417 N Boulder Creek CT
Dunlap, IL 61525-1500

Phone

(309) 678-8081

NPI assigned

Jan 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Bohannan Medical Dist., LLC

  • Durable Medical Equipment & Medical Supplies
  • Dunlap, IL
  • NPI 1225499080
  NPD (past) Authorized official

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1407213796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11417 N BOULDER CREEK CT",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615251500",
            "telephone_number": "309-678-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11417 N BOULDER CREEK CT",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615251500",
            "telephone_number": "309-678-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNAN",
        "first_name": "TOMMY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B&B Healthcare LLC
• Jessica Barrack
• Kristi Anne Bauer, OT
• Bethany Vanne Counseling, PLLC
• Bohannan Medical Dist., LLC
• Carrie Cafferty, RPH.
• Central Illinois Rheumatology PLLC
• Elizabeth Georgeanne Dennis
• Abani Dhewajoo, LCSW
• Ryan Jacob Dillard, MD

• Durable Medical Equipment & Medical Supplies in Dunlap, IL
• Providers in Dunlap, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.