Bonnie Mintz Anderson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

205069-4405 Issued in UT

Practice address

650 Komas Dr
Suite #200
Salt Lake City, UT 84108-1229

Phone

(801) 585-0394

Fax

(801) 581-8979

NPI assigned

Jun 23, 2006

Last updated

Oct 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• University of Utah Medical Center Psychiatry

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1821024217
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1881620714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 KOMAS DR",
            "address_2": "SUITE #200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081229",
            "telephone_number": "801-585-0394",
            "fax_number": "801-581-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 KOMAS DR",
            "address_2": "SUITE #200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081229",
            "telephone_number": "801-585-0394",
            "fax_number": "801-581-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BONNIE",
        "middle_name": "MINTZ",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "205069-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banderson2712@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Anderson
• Anne Katharine Anderson, D.O
• Ashley Anderson
• Bailee Marie Anderson
• Blane Evan Paul Anderson
• Bradley Anderson, M.D.
• Bradley Alan Anderson, D.C.
• Brennen Keith Anderson, MD
• Briawna Aika Anderson
• Brydon Anderson, RN

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2021; 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.