Individual provider Active NPI

Deborah Ann Bongers

  • Counselor
  • Appleton, WI
National Provider Identifier
1457750531
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2233-226 Issued in WI
Practice address
5497 W Waterford LN
Suite a
Appleton, WI 54913-8509
Phone
(920) 750-6120
Fax
(920) 750-6121
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2233-226 WI Primary

Addresses

Primary practice location

5497 W Waterford LN
Suite a
Appleton, WI 54913-8509

Mailing address

5497 W Waterford LN
Suite a
Appleton, WI 54913-8509
Phone (920) 750-6120

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
2233-226WIMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1457750531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5497 W WATERFORD LN",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138509",
            "telephone_number": "920-750-6120",
            "fax_number": "920-750-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5497 W WATERFORD LN",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138509",
            "telephone_number": "920-750-6120",
            "fax_number": "920-750-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGERS",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "2233-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.