NPIMap

Organization Active NPI

Bonner General Hospital, Inc

Doing business as Bonner General Urology

  • Urology Physician
  • Sandpoint, ID
National Provider Identifier
1801739339
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
BONNER GENERAL HOSPITAL, INC
Doing business as
Bonner General Urology
Practice address
423 N 3Rd Ave Ste 110
Sandpoint, ID 83864-1511
Phone
(208) 265-3342
Fax
(208) 263-1766
NPI assigned
Apr 10, 2026
Last updated
Aug 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
John Hennessy
Title
Ceo
Phone
(208) 265-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

423 N 3Rd Ave Ste 110
Sandpoint, ID 83864-1511

Mailing address

PO Box 1343
Sandpoint, ID 83864-0863
Phone (208) 265-1158

Other names 1

  • Bonner General Urology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040626000014 ID Part B Supplier - Clinic/Group Practice 4082690466 Receives reassigned benefits from 75 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandpoint, ID

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bonner Professional Compounding9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1801739339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1343",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640863",
            "telephone_number": "208-265-1158",
            "fax_number": "208-265-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N 3RD AVE STE 110",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641511",
            "telephone_number": "208-265-3342",
            "fax_number": "208-263-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNER GENERAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-265-1100"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonner General Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.