Individual provider Active NPI

Brian Scott Bonewell, CNP

  • Nurse Practitioner
  • Omak, WA
National Provider Identifier
1609419183
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61006049 Issued in WA
Practice address
810 Jasmine St
Omak, WA 98841-9578
Phone
(509) 826-1760
NPI assigned
Oct 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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 AP61006049 WA Primary

Addresses

Primary practice location

810 Jasmine St
Omak, WA 98841-9578

Mailing address

170 Viewmont
Okanogan, WA 98840-9424
Phone (208) 559-8580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191202001293 WA Practitioner - Nurse Practitioner 2062845266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okanogan County Public Hospital District No. 3Group PAC ID 6800707951, 89 clinicians

Practice addresses (Care Compare)

529 Jasmine St
Omak, WA 98841-9589
Phone (509) 826-1800

Hospital & facility affiliations

  • Mid Valley Hospital & Clinic Hospital, Omak, WA, CCN 501328
  • North Valley Hospital Hospital, Tonasket, WA, CCN 501321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61006049WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan County Public Hospital District No. 3 CurrentSince Oct 31, 2019 Accepting new patients
Okanogan County Public Hospital District No. 3 CurrentSince Oct 31, 2019 Accepting new patients

Locations

810 Jasmine St
Omak, WA 98841
Phone (509) 826-1760

529 Jasmine St
Omak, WA 98841
Phone (509) 826-1600

Interoperability endpoints

  • Direct secure messaging: bonewellb@mvhealth.cernerdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1609419183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 VIEWMONT",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988409424",
            "telephone_number": "208-559-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 JASMINE ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419578",
            "telephone_number": "509-826-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEWELL",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61006049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.