Mack Stuart Bonner Jr., MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

27125 Issued in NC

Practice address

590 S Trade St
Tryon, NC 28782-3714

Phone

(828) 859-0420

Fax

(828) 859-0422

NPI assigned

Aug 10, 2005

Last updated

Mar 15, 2010By the provider in NPPES

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Integrative Medical Associates, PLLC

  • Adult Medicine Physician
  • Tryon, NC
  • NPI 1578783239
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1407857501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 S TRADE ST",
            "city": "TRYON",
            "state": "NC",
            "postal_code": "287823714",
            "telephone_number": "828-859-0420",
            "fax_number": "828-859-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S TRADE ST",
            "city": "TRYON",
            "state": "NC",
            "postal_code": "287823714",
            "telephone_number": "828-859-0420",
            "fax_number": "828-859-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "MACK",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "27125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baker Family Chiropractic, PLLC
• Balanced Weight Loss and Wellness (Balanced Healthcare and Wellness)
• Daniel Joseph Becker, DC
• Ann P. Bezner, LCMHCS, LCAS
• James C Bond, O.D.
• Brian Carey MD PA Inc (Tryon Urgent and Family Care)
• Margaret Mary Burke, LCAS
• Lynn C Cabral
• William B. Caldwell, R.N.,L.M.F.T.
• Melanie Campbell-Cobb, RPH

• General Practice Physician in Tryon, NC
• Providers in Tryon, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.