Bonnieville Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

022802 Issued in PA

Legal business name

BONNIEVILLE INC.

Doing business as

Bonham Nursing Center

Practice address

477 Bonnieville Rd
Stillwater, PA 17878-9211

Phone

(570) 864-3174

Fax

(570) 864-3897

NPI assigned

Dec 7, 2005

Last updated

Aug 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James K. Bonham Jr.

Title

President

Phone

(570) 864-3174

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bonham Nursing Center Doing business as

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1851376370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 BONNIEVILLE RD",
            "city": "STILLWATER",
            "state": "PA",
            "postal_code": "178789211",
            "telephone_number": "570-864-3174",
            "fax_number": "570-864-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 BONNIEVILLE RD",
            "city": "STILLWATER",
            "state": "PA",
            "postal_code": "178789211",
            "telephone_number": "570-864-3174",
            "fax_number": "570-864-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIEVILLE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "BONHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-864-3174",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "022802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031076580001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonham Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 477 Holdings L.L.C.
• Keith G Bankes
• BNH LLC (Bonham Nursing and Rehabilitation Center)
• Nicole Rae Brodosky, RN
• Jody Danette Confer, DC
• Geisinger Health System
• Saranda Snyder

• Skilled Nursing Facility in Stillwater, PA
• Providers in Stillwater, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; 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.