NPIMap

Organization Active NPI

Klarisana Physician Services PLLC

  • Clinic/Center
  • Thornton, CO
National Provider Identifier
1902418965
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
KLARISANA PHYSICIAN SERVICES PLLC
Practice address
9195 Grant St Ste 130
Thornton, CO 80229-4348
Phone
(303) 535-7548
NPI assigned
Aug 20, 2020
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KLARISANA PHYSICIAN SERVICES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Dr. Carl John Bonnett, MDNPI 1427007327
Title
Medical Director
Phone
(303) 535-7548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X
Clinic/Center 261Q00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Pain Clinic/Center 261QP3300X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

9195 Grant St Ste 130
Thornton, CO 80229-4348

Mailing address

PO Box 736403
Dallas, TX 75373-6403
Phone (303) 535-7548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213000493 CO Part B Supplier - Clinic/Group Practice 1759659238 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
Practice locations: Centennial, CO; Denver, CO; Longmont, CO; Thornton, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Klarisana Phy SVCS PLLC4 organizations share this tax ID, including this one
Part of
Klarisana Phy SVCS PLLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9195 Grant St
Ste 130
Thornton, CO 80229
Phone (303) 535-7548

5005 W 81st Pl
Unit 403
Westminster, CO 80031
Phone (844) 455-2747

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1902418965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736403",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736403",
            "telephone_number": "303-535-7548",
            "fax_number": "888-504-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST STE 130",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294348",
            "telephone_number": "303-535-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLARISANA PHYSICIAN SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KLARISANA PHYSICIAN SERVICES PLLC",
        "enumeration_date": "2020-08-20",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "BONNETT",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "303-535-7548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.