Individual provider Active NPI

John Kent Bonney, MD

  • Family Medicine Physician
  • Waterville, ME
National Provider Identifier
1417071127
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
016198 Issued in ME
Practice address
16 Concourse West
Waterville, ME 04901
Phone
(207) 873-1036
Fax
(207) 873-1039
NPI assigned
Mar 19, 2007
Last updated
Dec 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 016198 ME Primary

Addresses

Primary practice location

16 Concourse West
Waterville, ME 04901

Mailing address

16 Concourse West
Waterville, ME 04901
Phone (207) 873-1036

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
016198MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Healthcare Systems Inland Hospital Family Medicine 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1417071127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CONCOURSE WEST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-873-1036",
            "fax_number": "207-873-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CONCOURSE WEST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-873-1036",
            "fax_number": "207-873-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEY",
        "first_name": "JOHN",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "016198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.