Mackenzie Bonnewitz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2530 N Elm PL
Broken Arrow, OK 74012-1285

Phone

(918) 994-1402

Fax

(918) 512-4806

NPI assigned

Aug 21, 2023

Last updated

Jan 7, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1487438560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 N ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121285",
            "telephone_number": "918-994-1402",
            "fax_number": "918-512-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 N ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121285",
            "telephone_number": "918-994-1402",
            "fax_number": "918-512-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEWITZ",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Bolin
• Cristine Brenda Bolley, MA LPC NCC
• Robbie Michelle Bollinger, PA-C
• Malaki Walker Bolton, DC
• John Ryan Bonaobra
• Bonny Crest Choice Living LLC
• Bonny Crest Home Healthcare, Inc
• Ayla Gabrielle Bonomi
• Mea Elizabeth Boone, PT
• Mitzi Davis Booth, MS, CCC-SLP

• Physician Assistant in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.