Active NPI
Thomas Bonk, ATC/L
- Athletic Trainer
- Ridgefield Park, NJ
National Provider Identifier
1982294682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 25MT00083900
- Practice address
- 1 Ozzie Nelson Dr
Ridgefield Park, NJ 07660-1201 - Phone
- (201) 970-0908
- NPI assigned
- Jan 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 25MT00083900 | NJ | Primary |
Addresses
Primary practice location
1 Ozzie Nelson Dr
Ridgefield Park, NJ 07660-1201
Mailing address
105 Aldrin Dr
Wanaque, NJ 07465-1217
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00083900 | NJ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1982294682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 ALDRIN DR",
"city": "WANAQUE",
"state": "NJ",
"postal_code": "074651217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 OZZIE NELSON DR",
"city": "RIDGEFIELD PARK",
"state": "NJ",
"postal_code": "076601201",
"telephone_number": "201-970-0908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONK",
"first_name": "THOMAS",
"credential": "ATC/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-26",
"last_updated": "2021-01-26",
"certification_date": "2021-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00083900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgefield Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.