Charles W. Bonner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS-00719-L Issued in PA

Practice address

5873 Forbes Ave
Pittsburgh, PA 15217-1601

Phone

(412) 422-9106

Fax

(412) 422-8180

NPI assigned

Sep 21, 2005

Last updated

Mar 15, 2024By 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1437145869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 MELVIN ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172210",
            "telephone_number": "412-422-9160",
            "fax_number": "412-422-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5873 FORBES AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152171601",
            "telephone_number": "412-422-9106",
            "fax_number": "412-422-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "CHARLES",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-00719-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "111914000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015318310004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORALHEALTH",
            "identifier": "111914000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "781511",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylee Bonk
• Wendpagnanda Bonkoungou
• Brian Peter Bonnar, LAT, ATC
• Anntonette Bonner
• Brian K Bonner, MD
• Cherie Bonner, MSW
• Lynette F Bonner
• Mary C Bonner, BA
• Tina Bonner, CRC
• Christopher Adrien Bonnet, MD

• Clinical Psychologist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.