Individual provider Active NPI

Bonita Smith St. John, AUD

  • Audiologist
  • Lititz, PA
National Provider Identifier
1861914822
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT000408L Issued in PA
Practice address
100 Highlands Dr Ste 307
Lititz, PA 17543-7692
Phone
(717) 625-0072
NPI assigned
Jul 12, 2017
Last updated
Jul 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT000408L PA Primary

Addresses

Primary practice location

100 Highlands Dr Ste 307
Lititz, PA 17543-7692

Mailing address

1041 Fondersmith Dr
Lancaster, PA 17601-4812
Phone (717) 333-6931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT000408LPAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1861914822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 FONDERSMITH DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014812",
            "telephone_number": "717-333-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLANDS DR STE 307",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437692",
            "telephone_number": "717-625-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "BONITA",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000408L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.