Individual provider Active NPI

Jerry Bono

  • Pharmacist
  • Gilbert, AZ
National Provider Identifier
1437569274
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S010517 Issued in AZ
Practice address
90 S Val Vista Dr
Gilbert, AZ 85296-1376
Phone
(480) 545-0547
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S010517 AZ Primary

Addresses

Primary practice location

90 S Val Vista Dr
Gilbert, AZ 85296-1376

Mailing address

90 S Val Vista Dr
Gilbert, AZ 85296-1376

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S010517AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1437569274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961376",
            "telephone_number": "480-545-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONO",
        "first_name": "JERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S010517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.