Active NPI
Nicole Cherie Bonfoey, CRNA
- Certified Registered Nurse Anesthetist
- Fairbanks, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 396
- Practice address
- 1650 Cowles St
Fairbanks, AK 99701-5998 - Phone
- (907) 452-8181
- NPI assigned
- Jan 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 33726 | AK | |
| Certified Registered Nurse Anesthetist | 367500000X | 396 | AK | Primary |
Addresses
Primary practice location
1650 Cowles St
Fairbanks, AK 99701-5998
Mailing address
PO Box 73720
Fairbanks, AK 99707-3720
Phone (907) 459-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120404000576 | AK | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5193985844 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tanana Valley Clinic LLC
Practice addresses (Care Compare)
1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 459-3500
Hospital & facility affiliations
- Fairbanks Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.86 of 100
- Quality
- 94.88
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33726 | AK | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Valley Clinic LLC | Current | Accepting new patients | |
| Tanana Valley Clinic LLC | Current | Accepting new patients |
Locations
1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181
1650 Cowles St
#100
Fairbanks, AK 99701
Phone (907) 451-8761
1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806
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.
-
- Multi-Specialty Clinic/Center
- Fairbanks, AK
- NPI 1073081485
Hospital & facility affiliations 1
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": "1325808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592524800000",
"number": "1639449796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 73720",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997073720",
"telephone_number": "907-459-3500",
"fax_number": "907-459-3526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COWLES ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015998",
"telephone_number": "907-452-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONFOEY",
"first_name": "NICOLE",
"middle_name": "CHERIE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-06",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "33726",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AK",
"license": "396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.