Individual provider Active NPI

Todd C Bonvallet, MD

  • Orthopaedic Surgery of the Spine Physician
  • Columbus, GA
National Provider Identifier
1952376337
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
42794 Issued in GA
Practice address
6262 Veterans Pkwy
Columbus, GA 31909-3540
Phone
(706) 324-6661
Fax
(706) 494-3306
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 42794 GA Primary

Addresses

Primary practice location

6262 Veterans Pkwy
Columbus, GA 31909-3540

Mailing address

6262 Veterans Pkwy
Columbus, GA 31909-3540
Phone (706) 324-6661

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NCOSM@Northside.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161219000696 GA Practitioner - Orthopedic Surgery 6002905049 Reassigns benefits to 1 organization
I20170302001780 AL Practitioner - Orthopedic Surgery 6002905049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

960 Johnson Ferry Rd
Suite 415
Atlanta, GA 30342-1601
Phone (404) 845-4380

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion22
Laminectomy or laminotomy (partial removal of spine bones)17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29071TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Surgery Associates, P.C. Orthopaedic Surgery of the Spine CurrentSince Sep 1, 1999 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Feb 12, 2020 Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

960 Johnson Ferry Rd
Ste 415
Sandy Springs, GA 30342
Phone (404) 252-7910

2306 Wisteria Dr
Ste 240
Snellville, GA 30078
Phone (678) 344-4944

1736 Gunbarrel Rd
Chattanooga, TN 37421
Phone (423) 756-6623

Interoperability endpoints

  • Direct secure messaging: todd_bonvallet_-_md@yourcarecommunity.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1952376337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-324-6661",
            "fax_number": "706-494-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-324-6661",
            "fax_number": "706-494-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVALLET",
        "first_name": "TODD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "42794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NCOSM@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "6262 Veterans Pkwy",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319093540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.