Bonnie Scanlan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TP000633B Issued in PA

Practice address

406 Franklin St
Smethport, PA 16749-1277

Phone

(814) 887-5655

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Olean General Hospital

  dba Bradford Regional Medical Cener

  • Intermediate Emergency Medical Technician
  • Bradford, PA
  • NPI 1205091899
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1700832979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 FRANKLIN ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491277",
            "telephone_number": "814-887-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLAN",
        "first_name": "BONNIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "TP000633B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027766530001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027766530003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04217983",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027766530002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix EMS Inc.
• Fayyaz Qadir, MD
• Rehabcare
• Annemarie Rich, LCSW
• Rlmosher LLC (Rural Regional EMS)
• Sarah Elizabeth Schwab, CRNP
• Sena Kean PA Opco (Sena Kean PA Nursing and Rehabilitation)
• Sena Kean SNF Operations LLC (Sena Kean Nursing and Rehabilitation Center)
• Seneca Highlands Intermediate Unit
• Seneca Highlands Intermediate Unit 9

• Family Nurse Practitioner in Smethport, PA
• Providers in Smethport, PA by specialty
• Family Nurse Practitioner in Pennsylvania

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