Active NPI
Madonna Kay Bonner, PAC
- Physician Assistant
- Elkins, WV
National Provider Identifier
1841271897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 00400
- Practice address
- 720 Beverly Pike
Elkins, WV 26241-9205 - Phone
- (304) 636-4585
- Fax
- (304) 637-4588
- NPI assigned
- Nov 8, 2005
- Last updated
- Mar 7, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00400 | WV | Primary |
Addresses
Primary practice location
720 Beverly Pike
Elkins, WV 26241-9205
Mailing address
720 Beverly Pike
Elkins, WV 26241-9205
Phone (304) 636-4585
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001837930 | Other | WV | MTN STATE SERVICE NUMBER |
| 734619 | Other | WV | NCPPO PROVIDER |
| 001837930 | Other | WV | MT ST BCBS SERVICE PROVIDER # |
| 3000318 | Other | WV | BRICKSTREET WORKERS COMP |
| FQ400 | Other | WV | HEALTH PLAN PROVIDER NO. |
| 001804181 | Other | WV | MTN STATE BC/BS PAY TO 1 |
| 1023337 | Other | WV | NCCPA |
| P00328118 | Other | WV | RAILROAD MEDICARE |
| 001967359 | Other | WV | MTN STATE BC/BS PAY TO 2 |
| 3810005145 | Medicaid | WV | |
| 00400 | Other | WV | WVBOM PA-C LICENSE |
| WV400 | Other | WV | HEALTH PLAN |
Other names 1
- Ms. Madonna Kay Varchetto
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Health Care Inc. | Past | Accepting new patients | |
| Valley Health Care, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Beverly, WV
- NPI 1073244810
-
dba Valley Health Care Elkins
- Federally Qualified Health Center (FQHC)
- Elkins, WV
- NPI 1710270954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1841271897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 BEVERLY PIKE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262419205",
"telephone_number": "304-636-4585",
"fax_number": "304-637-4588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 BEVERLY PIKE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262419205",
"telephone_number": "304-636-4585",
"fax_number": "304-637-4588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "MADONNA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "00400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MTN STATE SERVICE NUMBER",
"identifier": "001837930",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO PROVIDER",
"identifier": "734619",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MT ST BCBS SERVICE PROVIDER #",
"identifier": "001837930",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRICKSTREET WORKERS COMP",
"identifier": "3000318",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN PROVIDER NO.",
"identifier": "FQ400",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MTN STATE BC/BS PAY TO 1",
"identifier": "001804181",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA",
"identifier": "1023337",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00328118",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MTN STATE BC/BS PAY TO 2",
"identifier": "001967359",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810005145",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WVBOM PA-C LICENSE",
"identifier": "00400",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN",
"identifier": "WV400",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MADONNA",
"last_name": "VARCHETTO",
"middle_name": "KAY",
"prefix": "MS.",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.