Active NPI
Bonnie Lou Laudenbach, M.D.
- Obstetrics & Gynecology Physician
- Ashland, KY
National Provider Identifier
1750330171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35503
- Practice address
- 841 29TH St
Ashland, KY 41101-3019 - Phone
- (606) 324-1170
- Fax
- (606) 324-1077
- NPI assigned
- May 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35503 | KY | Primary |
Addresses
Primary practice location
841 29TH St
Ashland, KY 41101-3019
Mailing address
841 29TH St
Ashland, KY 41101-3019
Phone (606) 324-1170
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64007560 | Medicaid | KY | |
| 4037021 | Other | KY | AETNA |
| 000000107798 | Other | KY | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP576 | KY | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416960000000",
"number": "1750330171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "841 29TH ST",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411013019",
"telephone_number": "606-324-1170",
"fax_number": "606-324-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 29TH ST",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411013019",
"telephone_number": "606-324-1170",
"fax_number": "606-324-1077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAUDENBACH",
"first_name": "BONNIE",
"middle_name": "LOU",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2014-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "KY",
"license": "35503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64007560",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4037021",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000107798",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.