Active NPI
Bonny Dawn Henning, O.D.
- Optometrist
- Newark, OH
National Provider Identifier
1720086127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OH4745/T1549
- Practice address
- 1855 W Main St
Newark, OH 43055-1135 - Phone
- (614) 257-5200
- NPI assigned
- Jul 8, 2005
- Last updated
- Mar 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4745 | OH | |
| Optometrist | 152W00000X | OH4745/T1549 | OH | Primary |
Addresses
Primary practice location
1855 W Main St
Newark, OH 43055-1135
Mailing address
6607 Clark State Rd
Blacklick, OH 43004-9657
Phone (614) 204-4922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000116079 | Other | OH | ANTHEM BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4745 | OH | MD | Optometrist |
| OH4745/T1549 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haas Optical Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1720086127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6607 CLARK STATE RD",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "430049657",
"telephone_number": "614-204-4922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 W MAIN ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551135",
"telephone_number": "614-257-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNING",
"first_name": "BONNY",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-08",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "4745",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "OH4745/T1549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000116079",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.