Active NPI
Jared Anderson Bonnette, D.C.
- Chiropractor
- Alpine, UT
National Provider Identifier
1902864457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6970420-1202
- Practice address
- 40 W Main Street CT
Suite 175
Alpine, UT 84004-5600 - Phone
- (801) 770-3275
- Fax
- (810) 770-3300
- NPI assigned
- May 3, 2006
- Last updated
- Feb 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5486 | CO | |
| Chiropractor | 111N00000X | 6970420-1202 | UT | Primary |
Addresses
Primary practice location
40 W Main Street CT
Suite 175
Alpine, UT 84004-5600
Mailing address
40 W Main Street CT
Suite 175
Alpine, UT 84004-5600
Phone (801) 770-3275
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5486 | CO | MD | Chiropractor |
| 6970420-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic 1St, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neurology Chiropractor
- Longmont, CO
- NPI 1710128848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1902864457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 W MAIN STREET CT",
"address_2": "SUITE 175",
"city": "ALPINE",
"state": "UT",
"postal_code": "840045600",
"telephone_number": "801-770-3275",
"fax_number": "810-770-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 W MAIN STREET CT",
"address_2": "SUITE 175",
"city": "ALPINE",
"state": "UT",
"postal_code": "840045600",
"telephone_number": "801-770-3275",
"fax_number": "810-770-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNETTE",
"first_name": "JARED",
"middle_name": "ANDERSON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "5486",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "6970420-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpine, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.