Theodore Bonner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29912 Issued in WI

Practice address

8200 W Silver Spring Dr
Milwaukee, WI 53218-2552

Phone

(414) 760-3900

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992852891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532182552",
            "telephone_number": "414-760-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "29912",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Bonkowski, MD
• Alexandria Lee Bonne
• Valerie Jean Bonne, M.D.
• Julia Bonner, M.D.
• Michael H. Bonner, M.D.
• Danielle Bonnett, PA-C
• Noor Bachhuber Bontz, ACNPC-AG
• Diane S Book, MD
• Charmaine Sherese Boose
• Katherine Elizabeth Bopp, MD

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.