Lavonne M Charbonneau, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0002 Issued in ND

Practice address

114 3Rd St NE
Rolla, ND 58367-7137

Phone

(701) 477-3111

Fax

(701) 477-6342

NPI assigned

Nov 10, 2005

Last updated

Feb 18, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ND, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presentation Medical CenterGroup PAC ID 5991764045, shared by 3 NPIs, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Andrew's Hospital Hospital, Bottineau, ND, CCN 351307
• Presentation Medical Center Hospital, Rolla, ND, CCN 351316

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lavonne.charbonneau.1@11280.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Presentation Medical Center

  • Critical Access Hospital
  • Rolla, ND
  • NPI 1265404958
  Medicare reassignment NPD
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment
• Presentation Medical Center

  • Clinic/Center
  • Rolla, ND
  • NPI 1992014518
  NPD
• Rolla Clinic, P.C.

  • Family Medicine Physician
  • Rolla, ND
  • NPI 1215948435
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presentation Medical Center

  • Critical Access Hospital
  • Rolla, ND
  • NPI 1265404958
  Care Compare affiliation
• St. Andrew's Hospital

  dba SMP Health - St. Andrew's

  • Critical Access Hospital
  • Bottineau, ND
  • NPI 1801893706
  Care Compare affiliation

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1700867397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "address_2": "114 NE 3RD ST",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583670699",
            "telephone_number": "701-477-3111",
            "fax_number": "701-477-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 3RD ST NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583677137",
            "telephone_number": "701-477-3111",
            "fax_number": "701-477-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "LAVONNE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renae Ruth Williams Bonner
• Austen Boucher
• Caroline Bruce
• Myles Blake Brunelle
• Benjamin Bucher, FNP-BC
• Lilia Marcelina Cid, MD
• Tiffany Marie Clouse
• Commmunity Ambulance Service, Inc
• Carolyn Marie Counts
• Tammy R Counts

• Physician Assistant in Rolla, ND
• Providers in Rolla, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.