Active NPI
Bonnie Jane Gonzales, CNM
- Advanced Practice Midwife
- Fort Defiance, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- Practice address
- Corner of Route N12 and N7
Fort Defiance, AZ 86504 - Phone
- (928) 729-8000
- NPI assigned
- Feb 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | Primary |
Addresses
Primary practice location
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Mailing address
PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000
Other names 1
- Bonnie Wanlass
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| The Fort Defiance Indian Hospital Board, Incorporation | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients |
Locations
500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803
1375 E 19th Ave
Denver, CO 80218
Phone (303) 812-2000
1960 N Ogden St
Ste 320
Denver, CO 80218
Phone (303) 318-2620
4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885
1960 N Ogden St
Ste 330
Denver, CO 80218
Phone (303) 318-2610
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1477876639
TX
-
- Family Medicine Physician
- Denver, CO
- NPI 1083021083
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Denver, CO
- NPI 1083598874
-
- Obstetrics & Gynecology Physician
- Denver, CO
- NPI 1780201673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1548891005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865040649",
"telephone_number": "928-729-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORNER OF ROUTE N12 AND N7",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "86504",
"telephone_number": "928-729-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "BONNIE",
"middle_name": "JANE",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-03",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "WANLASS",
"credential": "CNM",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fort Defiance, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.