Active NPI
Andrew Bonner
- Specialist
- Colorado Springs, CO
National Provider Identifier
1639539612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 102 S Tejon St Ste 1100
Colorado Springs, CO 80903 - Phone
- (800) 249-1266
- NPI assigned
- Mar 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
102 S Tejon St Ste 1100
Colorado Springs, CO 80903
Mailing address
1301 E Orangewood Ave
Anaheim, CA 92805-6807
Phone (800) 249-1266
Other practice location 1
1406 Centaur Cir
Lafayette, CO 80026-1432
Phone (720) 837-2348
Other practice location 2
1406 Centaur Cir
Lafayette, CO 80026-1432
Phone (720) 837-2348
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Residential Solutions | 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.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Lafayette, CO
- NPI 1851650220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1639539612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 E ORANGEWOOD AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928056807",
"telephone_number": "800-249-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S TEJON ST STE 1100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80903",
"telephone_number": "800-249-1266"
}
],
"practiceLocations": [
{
"address_1": "1406 Centaur Cir",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "CO",
"postal_code": "800261432",
"country_code": "US",
"telephone_number": "720-837-2348",
"fax_number": "303-554-5657",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1406 Centaur Cir",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "CO",
"postal_code": "800261432",
"country_code": "US",
"telephone_number": "720-837-2348",
"fax_number": "303-554-5657",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BONNER",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-03",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.