NPIMap

Individual provider Active NPI

Kristi L. Bonnel-Phillips, PA-C

  • Family Medicine Physician
  • Basin, WY
National Provider Identifier
1962523126
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
164 Issued in WY
Practice address
156 North 6TH Street
Basin, WY 82410
Phone
(307) 568-2499
Fax
(307) 568-2699
NPI assigned
Apr 3, 2007
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 164 WY Primary

Addresses

Primary practice location

156 North 6TH Street
Basin, WY 82410

Mailing address

156 North 6TH Street
P.O. Box 388
Basin, WY 82410
Phone (307) 568-2499

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140611000924 WY Practitioner - Physician Assistant 8820212921 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

388 US Hwy 20 S
Basin, WY 82410-8902
Phone (307) 568-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Big Horn County Hospital District CurrentSince Nov 7, 2023 Accepting new patients
Hot Springs County Hospital District CurrentSince Dec 28, 2013 Accepting new patients
Hot Springs County Hospital District CurrentSince Dec 28, 2013 Accepting new patients
South Big Horn County Hospital District Past Accepting new patients

Locations

388 US Highway 20 S
Basin, WY 82410
Phone (307) 347-5810

150 E Arapahoe St
Thermopolis, WY 82443
Phone (307) 864-3121

Interoperability endpoints

  • Direct secure messaging: kbonnelphillips@threerivershealth.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1962523126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 NORTH 6TH STREET",
            "address_2": "P.O. BOX 388",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "82410",
            "telephone_number": "307-568-2499",
            "fax_number": "307-568-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 NORTH 6TH STREET",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "82410",
            "telephone_number": "307-568-2499",
            "fax_number": "307-568-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEL-PHILLIPS",
        "first_name": "KRISTI",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basin, WY

Sources for this page

Verify at the official NPI Registry.