Sidra Bonner, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4301115225 Issued in MI

Practice address

1500 E. Medical Center Drive
Taubman Center, 2ND Floor, Reception F
Ann Arbor, MI 48109-5332

Phone

(734) 936-5738

Fax

(734) 936-6927

NPI assigned

May 31, 2018

Last updated

May 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1790277390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "2920 TC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "TAUBMAN CENTER, 2ND FLOOR, RECEPTION F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095332",
            "telephone_number": "734-936-5738",
            "fax_number": "734-936-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "SIDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301115225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Suzanna Bonick, CRNA
• Phyllis Marie Boniface, MD
• Thomas Bonifer, M.D.
• Brandon Fredric Bonine
• Avelyn Rose Bonner
• James Clayton Bonnette, MD
• Russell Bonneville III
• Haley Bonnici
• Marianne Bonomo, NP
• Colleen Mary Bonser, DNP, APRN, FNP-BC

• Student in an Organized Health Care Education/Training Program in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.