Stevan D Bonom, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

054155 Issued in TN

Practice address

1924 Alcoa Hwy
U109
Knoxville, TN 37920-1511

Phone

(865) 305-9220

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Milligan Surgical ClinicGroup PAC ID 7911190707, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Milligan Surgical Clinic

  • Surgery Physician
  • Crossville, TN
  • NPI 1265746978
  Medicare reassignment Care Compare group NPD
• University Anesthesiologists, PLLC

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1073619466

  Nurse Anesthetist, Certified Registered

  NPD (past)
• University Anesthesiologists, PLLC

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1558479279
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1497728752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 TRANE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379196053",
            "telephone_number": "865-588-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "address_2": "U109",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOM",
        "first_name": "STEVAN",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN128520",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "054155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "054155",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN128520",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Douglas Bonn, D.O.
• Ashley Renee Bonnell, FN-P
• Jessica Lynn Bonner, CNM
• Jean Webb Bonnyman, IBCLC
• Julie Newton Bonom, CRNA
• Jacqueline Bonsu, PH.D.
• Rachelle Bontreger
• Abagail Morgan Booher
• Carrie S. Booher, PH.D.
• Lauren Witzler Booher, COTA/L

• Certified Registered Nurse Anesthetist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.