Individual provider Active NPI

Benjamin Bonser

  • Student in an Organized Health Care Education/Training Program
  • Saint Peter, MN
National Provider Identifier
1629424007
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
800 W College Ave
Saint Peter, MN 56082-1485
Phone
(719) 352-1214
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

800 W College Ave
Saint Peter, MN 56082-1485

Mailing address

PO Box 385
Palmer Lake, CO 80133-0385
Phone (719) 352-1214

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gustavus Adolphus College Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1629424007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 385",
            "city": "PALMER LAKE",
            "state": "CO",
            "postal_code": "801330385",
            "telephone_number": "719-352-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W COLLEGE AVE",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821485",
            "telephone_number": "719-352-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSER",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.