NPIMap

Individual provider Active NPI

Regina B Bonnevie-Rogers, MD

  • Internal Medicine Physician
  • Port Orchard, WA
National Provider Identifier
1982695128
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00035940 Issued in WA
Practice address
320 S Kitsap Blvd
Port Orchard, WA 98366-3778
Phone
(360) 876-7215
Fax
(360) 876-6721
NPI assigned
Nov 4, 2005
Last updated
Apr 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00035940 WA Primary

Addresses

Primary practice location

320 S Kitsap Blvd
Port Orchard, WA 98366-3778

Mailing address

PO Box 960
Bremerton, WA 98337-0212
Phone (360) 478-2366

Other identifiers 2

IdentifierTypeStateIssuer
8229064MedicaidWA
110180983OtherRR MEDICARE

Other names 1

  • Regina B Bonnevie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040312001208 WA Practitioner - Internal Medicine 6507755972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

320 S Kitsap Blvd
Port Orchard, WA 98366-3778
Phone (360) 377-3776

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00035940WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services Internal Medicine CurrentSince Apr 27, 2022 Accepting new patients
Peninsula Community Health Services Internal Medicine Current Accepting new patients
Peninsula Community Health Services Past Accepting new patients

Locations

31 NE State Route 300
Ste 200
Belfair, WA 98528
Phone (360) 377-3779

616 6th St
Bremerton, WA 98337
Phone (360) 478-2366

320 S Kitsap Blvd
Port Orchard, WA 98366
Phone (360) 876-7215

19917 7th Ave NE
Ste 205
Poulsbo, WA 98370
Phone (360) 697-7636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13902/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: regina.bonnevie-rogers.1@13902.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1982695128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983370212",
            "telephone_number": "360-478-2366",
            "fax_number": "360-373-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S KITSAP BLVD",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663778",
            "telephone_number": "360-876-7215",
            "fax_number": "360-876-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEVIE-ROGERS",
        "first_name": "REGINA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00035940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8229064",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110180983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINA",
            "last_name": "BONNEVIE",
            "middle_name": "B",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.