Bethann Bonner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

29141 Issued in IA

Practice address

1500 Associates Dr
Dubuque, IA 52002-2201

Phone

(563) 584-4440

Fax

(563) 584-4295

NPI assigned

May 10, 2006

Last updated

Nov 25, 2009By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Medical Center Inc

  dba Tamarack Health Ashland Medical Center

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment NPD
• Memorial Medical Center Inc

  dba Tamarack Health Ashland Clinic

  • Rural Health Clinic/Center
  • Ashland, WI
  • NPI 1770255937
  NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1811946320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4440",
            "fax_number": "563-584-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "BETHANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "29141",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "25904",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094193",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Elizabeth Boge, PA
• Kebba Bojang, PHARM. D
• Brooke Bojar
• Daniel L. Bolgren, D.D.S
• Rebekah Sue Bond, M.D.
• Carrie K Borchardt, DDS
• Tricia Sullivan Borelli, LMHC
• Allison Bormann
• Abigail N. Bottorff, TLMHC, MA COUNSELING
• Richelle C Bouska, MHC

• Pediatrics Physician in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.