Individual provider Active NPI

Bonni Lyn Roach, APRN-CNP

  • Family Nurse Practitioner
  • Point Pleasant, WV
National Provider Identifier
1417517517
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
103779 Issued in WV
Practice address
3471 Ohio River Rd
Point Pleasant, WV 25550-4401
Phone
(304) 857-6494
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 103779 WV Primary

Addresses

Primary practice location

3471 Ohio River Rd
Point Pleasant, WV 25550-4401

Mailing address

3741 Ohio River Rd
Point Pleasant, WV 25550

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

State licenses

LicenseStateTypeSpecialty
103779WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hope for Tomorrow, LLC CurrentSince Jul 9, 2023 Accepting new patients

Locations

3471 Ohio River Rd
Point Pleasant, WV 25550
Phone (304) 812-5965

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1417517517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 OHIO RIVER RD",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "25550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 OHIO RIVER RD",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255504401",
            "telephone_number": "304-857-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "BONNI",
        "middle_name": "LYN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2023-07-05",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "103779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Pleasant, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.