Bonnie Lynn Wood, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8250781-1206 Issued in UT

Practice address

1036 E Riverside Dr
St George, UT 84790-4477

Phone

(435) 656-0022

Fax

(435) 634-8166

NPI assigned

May 14, 2012

Last updated

May 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bonnie@richenseyecenter.direct.eyemdemr.com
• FHIR API: https://api.platform.athenahealth.com/4270/brand/1/csg/1/fhir/r4

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.

• Sharon Richens MD Eye Physician & Surgeon PC

  dba Richens Eye Center

  • Ophthalmology Physician
  • St George, UT
  • NPI 1891892063
  Medicare reassignment
• Advanced Family Health Care, Inc.

  • Family Medicine Physician
  • Cedar City, UT
  • NPI 1225317043
  NPD (past)

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1457610255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904477",
            "telephone_number": "435-656-0022",
            "fax_number": "435-634-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904477",
            "telephone_number": "435-656-0022",
            "fax_number": "435-634-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8250781-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "8750781-1206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teyawna Wombaker
• Women's Wellness, LLC
• Alice M. Wong, MD
• Gayle Wong, M.D.
• Anne Wood
• Chelsea Wood, PAC
• Christopher Rae Wood, OD
• Jennifer Ruth Wood
• Jonathan Murray Wood
• Russell Wood

• Medical Physician Assistant in St George, UT
• Providers in St George, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.