Bonnie A. Lazor, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

38890 Issued in KY

Practice address

1110 Oakwood Ave
Oakwood, OH 45419

Phone

(419) 206-1249

Fax

(937) 567-0670

NPI assigned

May 20, 2006

Last updated

Mar 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Bonnie Lazor-McDaniel Former name

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vintage Care Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1376598763
  Medicare reassignment NPD Authorized official
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY

  Medicare reassignment NPD
• Advanced Healthcare Associates LLP

  • Geriatric Medicine (Internal Medicine) Physician
  • Elwood, IN
  • NPI 1841225091
  NPD (past)
• Nazareth Home Inc

  • Skilled Nursing Facility
  • Louisville, KY
  • NPI 1346312824
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1548214059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 OAKWOOD AVE",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454192911",
            "telephone_number": "419-206-1249",
            "fax_number": "937-567-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 OAKWOOD AVE",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "45419",
            "telephone_number": "419-206-1249",
            "fax_number": "937-567-0670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Pennyroyal Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402233349",
            "country_code": "US",
            "telephone_number": "502-376-1957",
            "fax_number": "502-245-1322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZOR",
        "first_name": "BONNIE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "KY",
            "license": "38890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50011328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "743176351A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64089535",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000479105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2746336000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00343016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "LAZOR-MCDANIEL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Irma B Johnston, PSYD
• Karefirst Ohio
• Aubrey Marie Kern
• Jane O Key, RDN
• Mary Kunesh, MD
• Biaunka Lee, NURSE PRACTITIONER
• Shelby Link, MS, LPCC
• Nicholas Lofton, PHARMD, RPH
• Cheryl L Mahoney
• Joe Maksoudian

• Geriatric Medicine (Internal Medicine) Physician in Oakwood, OH
• Providers in Oakwood, OH by specialty
• Geriatric Medicine (Internal Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.