Individual provider Active NPI

Nickie Bonar, LMT

  • Massage Therapist
  • Omaha, NE
National Provider Identifier
1619309580
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
3033 Issued in NE
Practice address
1710 N 144TH St
Suite B
Omaha, NE 68154-4715
Phone
(402) 237-9110
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 3033 NE
Massage Therapist 225700000X 3033 NE Primary
Reflexologist 173C00000X

Addresses

Primary practice location

1710 N 144TH St
Suite B
Omaha, NE 68154-4715

Mailing address

11698 Meredith Ave
Omaha, NE 68164-2226
Phone (402) 237-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1619309580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11698 MEREDITH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681642226",
            "telephone_number": "402-237-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N 144TH ST",
            "address_2": "SUITE B",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544715",
            "telephone_number": "402-237-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAR",
        "first_name": "NICKIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NE",
            "license": "3033",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NE",
            "license": "3033",
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.