Julie A Bongers

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

272601 Issued in MN

Practice address

17810 Ames CT
Faribault, MN 55021-7933

Phone

(507) 838-5991

Fax

(507) 838-5991

NPI assigned

Aug 31, 2017

Last updated

Aug 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1811415672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17810 AMES COURT",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-838-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17810 AMES CT",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550217933",
            "telephone_number": "507-838-5991",
            "fax_number": "507-838-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGERS",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "272601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN ADULT FOSTER CARE LICENSE NUMBER",
            "identifier": "272601",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Blomquist
• Patricia Elena Blue, CNM
• Mandy Rae Blume, MS RN CGNP
• Maria Bohl, PT
• Jayne Bongers
• Faith Borchert
• Tanya Borchert
• Sheryl Borka
• Boyes Pharmacy
• William Howard Boyes, R.PH.

• Assisted Living Facility in Faribault, MN
• Providers in Faribault, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.