Active NPI
Micah Bonola, DC
- Chiropractor
- Fort Worth, TX
National Provider Identifier
1770025934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13249
- Practice address
- 1300 W. Rosedale St, Ste. a
Fort Worth, TX 76104 - Phone
- (817) 377-4011
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR.0007242 | CO | |
| Chiropractor | 111N00000X | 13249 | TX | Primary |
Addresses
Primary practice location
1300 W. Rosedale St, Ste. a
Fort Worth, TX 76104
Mailing address
1800 Barrington Dr
Roanoke, TX 76262
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 |
|---|---|---|---|
| CHR.0007242 | CO | MD | Chiropractor |
| 13249 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1770025934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 BARRINGTON DR",
"city": "ROANOKE",
"state": "TX",
"postal_code": "76262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W. ROSEDALE ST, STE. A",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76104",
"telephone_number": "817-377-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONOLA",
"first_name": "MICAH",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "CHR.0007242",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.