Kelly Bonner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110002450 Issued in VA

Practice address

2216 Princess Anne St
Suite 204
Fredericksburg, VA 22401-3300

Phone

(540) 371-7118

Fax

(540) 371-3248

NPI assigned

May 1, 2007

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1487875381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 PRINCESS ANNE ST",
            "address_2": "SUITE 204",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013300",
            "telephone_number": "540-371-7118",
            "fax_number": "540-371-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 PRINCESS ANNE ST",
            "address_2": "SUITE 204",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013300",
            "telephone_number": "540-371-7118",
            "fax_number": "540-371-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Bonanca, LPC
• Megan Anne Bone, LAT, ATC
• Bones Inc Dba Schulz Chiropractic Center
• John Boniface Jr., M.D.
• Haley Bonilla, MT
• Mary Elizabeth Boone, PA-C
• Kaylee Booth
• Megan Elizabeth Booth, D.P.T.
• Amber Boozer, BCBA
• Connie Marie Borkowski, MPH

• Medical Physician Assistant in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.