Charles Anthony Bongiorno, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME131584 Issued in FL

Practice address

1940 Harrison Ave
Panama City, FL 32405-4542

Phone

(850) 763-0017

Fax

(850) 692-5862

NPI assigned

Jun 11, 2008

Last updated

Aug 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Virginia Commonwealth University, School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald Coast Behavioral Hospital LLCGroup PAC ID 3274687363, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emerald Coast Behavioral Hospital, LLC

  • Psychiatric Hospital
  • Panama City, FL
  • NPI 1578795332

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Indian River Health Services Inc

  dba Behavioral Health Center

  • Psychiatry Physician
  • Vero Beach, FL
  • NPI 1710933031
  Medicare reassignment NPD
• Asana Integrated Medical Group PC

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1396783379

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1417117714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-692-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-692-5862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1180 College Dr",
            "address_purpose": "LOCATION",
            "city": "Rock Springs",
            "state": "WY",
            "postal_code": "829015863",
            "country_code": "US",
            "telephone_number": "307-352-8161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD441952",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD441952",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME131584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee R Bohn, MD
• Kevin Bolter, RPH
• Beverly Ann Bond, ARNP-C
• Sara Bond
• William D Bone, M.D.
• Vyneri Inverness Bonner
• Joanne Booker
• Linda A Bookout, CRNA
• Loyshay Boone
• Eileen Booth, LMHC

• Psychiatry Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.