NPIMap

Organization Active NPI

Bonifay NSG & Rehab

  • Assisted Living Facility
  • Bonifay, FL
National Provider Identifier
1710080890
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
SNF10570961 Issued in FL
Legal business name
BONIFAY NSG & REHAB
Practice address
304 N Brock Ave
Bonifay, FL 32425
Phone
(850) 547-9289
Fax
(850) 547-2575
NPI assigned
Sep 6, 2006
Last updated
Jul 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Mrs. Nancy E Hall, NHA
Title
Administrator
Phone
(850) 547-9289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X SNF10570961 FL Primary

Addresses

Primary practice location

304 N Brock Ave
Bonifay, FL 32425

Mailing address

304 N Brock Ave
Bonifay, FL 32425
Phone (850) 547-9289

Other identifiers 1

IdentifierTypeStateIssuer
026344300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Bonifay NSG Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1710080890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N BROCK AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "32425",
            "telephone_number": "850-547-9289",
            "fax_number": "850-547-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N BROCK AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "32425",
            "telephone_number": "850-547-9289",
            "fax_number": "850-547-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONIFAY NSG & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-547-9289",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "SNF10570961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026344300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.