WENDELL R BONNER


Address: 4212 Grand Ave, Duluth, MN 55807
Phone: 2187863500

WENDELL R BONNER (NPI# 1033140660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033140660
Entity Type Individual
Full Name WENDELL R BONNER
Credential MD
Practice Address 4212 Grand Ave
Duluth
MN 55807
Mailing Address 4212 Grand Avenue
Duluth
MN 55807
Practice Telephone 2187863500
Mailing Telephone 2187863500
Enumeration Date 2006-07-05
Last Update Date 2011-05-06
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 38966 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 380838600 05

Office Location

Street Address 4212 GRAND AVE
City DULUTH
State MN
Zip Code 55807

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205882594 Adam Charles Swank Family Medicine 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807-2737 2006-05-26
1134743586 Erika K Ehlers Registered Nurse 4212 Grand Ave, Duluth, MN 55807-2737 2020-06-02
1457991804 Matt Kleven Physician Assistant 4212 Grand Ave, Duluth, MN 55807-2737 2020-01-14
1588204044 Matthew G Schull Physician Assistant 4212 Grand Ave, Duluth, MN 55807-2737 2020-01-13
1124675566 Amos Restad Nurse Practitioner 4212 Grand Ave, Duluth, MN 55807-2737 2019-08-21
1164089702 Sarah M Jackson Physical Therapist 4212 Grand Ave, Duluth, MN 55807-2737 2019-05-20
1023578515 Megan Elizabeth Markes Physician Assistant 4212 Grand Ave, Duluth, MN 55807-2737 2019-03-21
1134685035 Anthony C Guidone Nurse Practitioner 4212 Grand Ave, Duluth, MN 55807-2737 2019-02-15
1679051791 Brianna N Buske Physical Therapist 4212 Grand Ave, Duluth, MN 55807-2737 2018-07-31
1174075246 Lucette Vankessel Nurse Practitioner 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807-2737 2016-10-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568918126 Jaime Lynn Mallory Counselor 4000 W 9th St., Duluth, MN 55807 2016-09-01
1568817138 Fathers Rise Together Community/Behavioral Health 319 N 22nd Ave West, Duluth, MN 55807 2016-05-02
1558660357 Melissa June Huray Counselor 326 North Central Avenue, Duluth, MN 55807 2011-03-18
1376757682 Chiropractic Health Center P A Chiropractor 215 North Central Ave, Duluth, MN 55807 2007-05-09
1639235914 Mark Andrew Nelson Albee Social Worker 4214 Grand Avenue, Duluth Clinic-west, Duluth, MN 55807 2006-12-29
1851457758 Northwood Children's Services, Inc. Counselor 4000 W 9th St, Duluth, MN 55807 2006-12-28
1679934012 Rebecca Ann Peterson Nurse Practitioner 4325 Grand Ave, Duluth, MN 55807 2016-03-13
1225525645 Mark J Engebretson Social Worker 5814 Elinor St, Duluth, MN 55807-1215 2018-04-20
1235756784 Allissa Rardin Social Worker 720 N Central Ave, Duluth, MN 55807-1305 2020-07-01
1588898829 Angela Sue Rosas Registered Nurse 618 1/2 N 56th Ave W, Duluth, MN 55807-1325 2009-05-14
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811553084 Clement Ayanbadejo LLC Family Medicine 2282 Meadow Church Rd Ste 200, Duluth, GA 30097-5318 2019-05-14
1902391923 Young-tae Kim Family Medicine 3610 Peachtree Industrial Blvd Ste 100, Duluth, GA 30096-5139 2018-06-22
1659655538 Primary Care of Atlanta Family Medicine 4124 Chattahoochee Trce, Ste 103, Duluth, GA 30097-2147 2011-10-10
1639462997 James F Conniff Family Medicine Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 2011-05-19
1497087126 St. Luke's Hospital of Duluth Family Medicine 6351 E. Superior St., Duluth, MN 55804-2545 2010-02-05
1861729816 Mark Steven Grimsley Family Medicine 1611 Satellite Blvd Ste 3, Duluth, GA 30097 2009-11-12
1154552990 Clement O Ayanbadejo Family Medicine 2282 Meadow Church Rd, Ste 200, Duluth, GA 30097-5318 2009-07-28
1891950457 Liem Chi Ngo Family Medicine 4470 Satellite Blvd, Suite 204, Duluth, GA 30096-8851 2008-07-23
1962663302 Martin Charles Hinz Family Medicine 1150 88th Ave W, Duluth, MN 55808-1505 2008-06-18
1447422506 Onelio Emilio Perdomo Family Medicine 3750 Venture Drive, Suite 130, Duluth, GA 30096-1808 2008-03-28
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City DULUTH
Zip Code 55807

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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