NPIMap

Organization Active NPI

Bonnell Health and Wellness

Doing business as Bonnell Health and Wellness Center

  • Clinic/Center
  • Carthage, TN
National Provider Identifier
1629620950
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BONNELL HEALTH AND WELLNESS
Doing business as
Bonnell Health and Wellness Center
Practice address
19 Bonnell Lane
Suite a
Carthage, TN 38030
Phone
(618) 588-0880
Fax
(615) 588-0881
NPI assigned
Jul 16, 2019
Last updated
Jan 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
FUTURA MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Darce Latsis
Title
Operations Manager
Phone
(615) 588-0880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

19 Bonnell Lane
Suite a
Carthage, TN 38030

Mailing address

560 S 300 E Ste 275
Salt Lake City, UT 84111-3586
Phone (801) 441-1002

Other names 1

  • Bonnell Health and Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blendtec Health Center25 organizations share this tax ID, including this one
Part of
Blendtec Health Center

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1629620950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S 300 E STE 275",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113586",
            "telephone_number": "801-441-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BONNELL LANE",
            "address_2": "SUITE A",
            "city": "CARTHAGE",
            "state": "TN",
            "postal_code": "38030",
            "telephone_number": "618-588-0880",
            "fax_number": "615-588-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNELL HEALTH AND WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FUTURA MEDICAL CLINIC",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "LATSIS",
        "authorized_official_first_name": "DARCE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "615-588-0880"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonnell Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bonnell Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carthage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.