Bonnie Wong, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TL-4526 Issued in CO

Practice address

902 Lakeview Ave
Southern Colorado Family Medicine
Pueblo, CO 81004-3798

Phone

(719) 557-5872

NPI assigned

Jul 17, 2012

Last updated

Jul 17, 2012By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1437404415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 WYOMING AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043752",
            "telephone_number": "206-999-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "address_2": "SOUTHERN COLORADO FAMILY MEDICINE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043798",
            "telephone_number": "719-557-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BONNIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL-4526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO TRAINING LICENSE NUMBER",
            "identifier": "TL-4526",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Wohlwend, DDS
• Yonas Woldekiristos, MD
• Kristina Marie Wolf, FNP-BC
• Desiree Wolfe, RN
• Womens Health Center Inc
• Kevin Wayne Wood
• Michael M Wood, M.D.
• Teresa Elaine Wood, MHR
• Fonda Woodman
• Gloria S Woodman, RPH

• Family Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.