Organization Active NPI

Shawn Bonsell MD PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Dallas, TX
National Provider Identifier
1730366683
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
K8016 Issued in TX
Legal business name
SHAWN BONSELL MD PA
Practice address
1015 N Carroll Ave Ste 2000
Dallas, TX 75204-6607
Phone
(214) 824-7744
Fax
(214) 824-7755
NPI assigned
Jan 23, 2008
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Shawn C Bonsell, M.D.NPI 1558373423
Title
Doctor
Phone
(214) 824-7744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X K8016 TX Primary

Addresses

Primary practice location

1015 N Carroll Ave Ste 2000
Dallas, TX 75204-6607

Mailing address

1015 N Carroll Ave Ste 2000
Dallas, TX 75204-6607
Phone (214) 824-7744

Other identifiers 1

IdentifierTypeStateIssuer
146533803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051107000519 TX Part B Supplier - Clinic/Group Practice 2062430283 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX
O20180228002532 TX DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Sports Medicine 2062430283 Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1730366683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N CARROLL AVE STE 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046607",
            "telephone_number": "214-824-7744",
            "fax_number": "214-824-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N CARROLL AVE STE 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046607",
            "telephone_number": "214-824-7744",
            "fax_number": "214-824-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN BONSELL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "BONSELL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "214-824-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "K8016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146533803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.