Individual provider Active NPI

Bonita Faye Conner, FNP

  • Nurse Practitioner
  • Ogema, MN
National Provider Identifier
1497791115
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R1180880 Issued in MN
Practice address
40520 Co Hwy 34
White Earth Health Center
Ogema, MN 56569
Phone
(218) 983-4300
Fax
(218) 983-6217
NPI assigned
Jun 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R1180880 MN Primary

Addresses

Primary practice location

40520 Co Hwy 34
White Earth Health Center
Ogema, MN 56569

Mailing address

2205 290TH St
Waubun, MN 56589

Other identifiers 3

IdentifierTypeStateIssuer
585241045697OtherPREFERRED ONE
0121298OtherMEDICA
376G7C0OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20050920000805 MN Practitioner - Nurse Practitioner 5799729281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Pleasant Ave S
Park Rapids, MN 56470-1431
Phone (218) 732-3311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph's Area Health Services CurrentSince Jun 1, 2010 Accepting new patients
St. Joseph's Area Health Services Current Accepting new patients

Locations

3314 Solutions Ctr
Chicago, IL 60677

600 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-3311

4784 Amber Valley Pkwy S
Fargo, ND 58104

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497791115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 290TH ST",
            "city": "WAUBUN",
            "state": "MN",
            "postal_code": "56589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 CO HWY 34",
            "address_2": "WHITE EARTH HEALTH CENTER",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "56569",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "BONITA",
        "middle_name": "FAYE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1180880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "585241045697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0121298",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "376G7C0",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogema, MN

Sources for this page

Verify at the official NPI Registry.