Bonny Crest Choice Living LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BONNY CREST CHOICE LIVING LLC

Practice address

700 W Fort Worth St
Broken Arrow, OK 74012-3719

Phone

(918) 949-4555

Fax

(918) 933-5352

NPI assigned

Nov 15, 2022

Last updated

Nov 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Chris Jumbo

Title

Director/Administrator

Phone

(918) 949-4555

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1578272969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W FORT WORTH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123719",
            "telephone_number": "918-949-4555",
            "fax_number": "918-933-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FORT WORTH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123719",
            "telephone_number": "918-949-4555",
            "fax_number": "918-933-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNY CREST CHOICE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "JUMBO",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR/ADMINISTRATOR",
        "authorized_official_telephone_number": "918-949-4555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "petero@bonnycrest.com",
            "affiliation": "N",
            "endpointDescription": "Email addresss",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "accept attachments",
            "address_1": "700 W Fort Worth St",
            "city": "Broken Arrow",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740123719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cristine Brenda Bolley, MA LPC NCC
• Robbie Michelle Bollinger, PA-C
• Malaki Walker Bolton, DC
• John Ryan Bonaobra
• Mackenzie Bonnewitz, PA-C
• Bonny Crest Home Healthcare, Inc
• Ayla Gabrielle Bonomi
• Mea Elizabeth Boone, PT
• Mitzi Davis Booth, MS, CCC-SLP
• Maresa Boshoff, PHARMACIST

• Case Management Agency in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Case Management Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.