Thomas Bontrager, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34001157A Issued in IN

Practice address

5401 Shelby St
Indianapolis, IN 46227-4216

Phone

(317) 788-4451

Fax

(317) 788-4451

NPI assigned

Mar 20, 2007

Sex

Male

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

Practice roles

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.

• Southside Youth Council, Inc

  dba Reach For Youth, Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1003994245
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841315785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SHELBY ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462274216",
            "telephone_number": "317-788-4451",
            "fax_number": "317-788-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SHELBY ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462274216",
            "telephone_number": "317-788-4451",
            "fax_number": "317-788-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTRAGER",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001157A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "34001157A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Bonnin, M.D.
• Courtney Sue Bono, NP
• Kiven Bonongwe, FNP
• Carrie F Bonsack, CNM
• Kylie Rochelle Bontrager, D.D.S., M.S.D.
• Jacob Boo, LMHC
• Jenelle N Boo, PH.D.
• Diane Irene Boody
• Talia Rae Booher, MB BCH BAO
• Blair Elizabeth Book, CAA

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.