Active NPI
Bonnie Bea Kiser
- Marriage & Family Therapist
- Fort Wayne, IN
National Provider Identifier
1881603033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT 35001593A
- Practice address
- 3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721 - Phone
- (260) 407-7285
- Fax
- (260) 407-0094
- NPI assigned
- Aug 5, 2006
- Last updated
- Dec 9, 2009
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT 35001593A | IN | Primary |
Addresses
Primary practice location
3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Mailing address
3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Phone (260) 407-7285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200530260A | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT 35001593A | IN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Counseling and Psychological Services, PC | Past | Accepting new patients | |
| Cornerstone Counseling & Consulting, P.C, | 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.
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- NPI 1801067012
-
- Psychologist
- Fort Wayne, IN
- NPI 1609059146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260316800000",
"number": "1881603033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3948 NEW VISION DR STE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451721",
"telephone_number": "260-407-7285",
"fax_number": "260-407-0094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3948 NEW VISION DR STE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451721",
"telephone_number": "260-407-7285",
"fax_number": "260-407-0094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISER",
"first_name": "BONNIE",
"middle_name": "BEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2009-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "LMFT 35001593A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200530260A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.