MS. RENE BONTRAGER (NPI# 1164837563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164837563 |
| Entity Type | Individual |
| Full Name | MS. RENE BONTRAGER |
| Credential | CRNP |
| Practice Address |
220 Hospital Dr Jackson AL 36545-2459 |
| Practice Telephone | 2512461210 |
| Practice Fax Number | 2512461219 |
| Mailing Telephone | 2512461210 |
| Mailing Fax Number | 2512461219 |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-047020 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
1-047020 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
220 HOSPITAL DR |
| City | JACKSON |
| State | AL |
| Zip Code | 36545-2459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598770943 | Gilliard Health Services | General Acute Care Hospital | 220 Hospital Dr, Jackson, AL 36545-2459 | 2006-07-31 |
| 1265802235 | Jackson Medical Center LLC | Clinic/Center | 220 Hospital Dr, Jackson, AL 36545-2459 | 2015-10-02 |
| 1891180089 | Jackson Medical Center, LLC | Clinic/Center | 220 Hospital Dr, Jackson, AL 36545-2459 | 2015-04-03 |
| 1013320167 | Carla Ann Baxley | Nurse Practitioner | 220 Hospital Dr, Jackson, AL 36545-2459 | 2014-06-06 |
| 1033540232 | Aikam Health | Clinic/Center | 220 Hospital Dr, Jackson, AL 36545-2459 | 2013-12-12 |
| 1053638528 | Monroeville Radiation Oncology | Specialist | 220 Hospital Dr, Jackson, AL 36545-2459 | 2010-04-23 |
| 1841453354 | Pulmonary Associates of Mobile, PC | Internal Medicine | 220 Hospital Dr, Jackson, AL 36545-2459 | 2008-07-03 |
| 1790954733 | Gilliard Health Services | Home Health | 220 Hospital Dr, Jackson, AL 36545-2459 | 2008-02-25 |
| 1043430226 | Jackson Medical Center, L.L.C. | General Acute Care Hospital | 220 Hospital Dr, Jackson, AL 36545-2459 | 2007-04-27 |
| 1952427874 | Jackson Medical Center, LLC | General Acute Care Hospital | 220 Hospital Dr, Jackson, AL 36545-2459 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487720355 | Alabama Orthopaedic Clinic, PC | Orthopaedic Surgery | 220 Hospital Ave, Jackson, AL 36545 | 2006-11-24 |
| 1871094300 | Kristin Ford Anderson | Physical Therapist | 1711 College Ave, Jackson, AL 36545 | 2018-02-21 |
| 1447567250 | Jamal Randall | Physical Therapist | 1711 College Avenue, Jackson, AL 36545-0037 | 2010-09-01 |
| 1538186846 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4206 N College Ave, Jackson, AL 36545-2019 | 2006-07-16 |
| 1902987399 | Wal-mart Stores East, Lp | Technician/Technologist | 4206 N College Ave, Jackson, AL 36545-2019 | 2006-10-18 |
| 1285671792 | Aseracare Hospice - Jackson, LLC | Hospice Care, Community Based | 4115 N College Ave, Jackson, AL 36545-2022 | 2006-06-01 |
| 1396353363 | Health Now Jackson, LLC | Durable Medical Equipment & Medical Supplies | 3802 N College Ave Ste 107, Jackson, AL 36545-2046 | 2020-07-16 |
| 1245342070 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 215 Walker Springs Rd, Jackson, AL 36545-2136 | 2006-08-31 |
| 1851917504 | Medevac Alabama Inc | Ambulance | 3738 N College Ave, Jackson, AL 36545-2225 | 2020-06-18 |
| 1497739007 | Brian Keith Graham | Chiropractor | 1120 College Ave, Jackson, AL 36545-2405 | 2005-12-06 |
| Find all providers in zip 36545 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113627 | Jessicah Blasdel | Nurse Practitioner | 113 W Michigan Ave, Jackson, MI 49201-1340 | 2020-10-31 |
| 1801406335 | Jade Russell | Nurse Practitioner | 2205 W Morrell St, Jackson, MI 49203-1357 | 2020-08-10 |
| 1992315212 | Patrecia Campbell | Nurse Practitioner | 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 | 2020-08-01 |
| 1669008926 | Kristine Edwards | Nurse Practitioner | 723 Woodlawn Ave, Jackson, MI 49203-2921 | 2020-03-19 |
| 1295366391 | Christy White | Nurse Practitioner | 363 Old Pinson Rd, Jackson, TN 38301-9576 | 2020-01-28 |
| 1972141620 | Primary Care - Bemis, LLC | Nurse Practitioner | 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 | 2019-12-12 |
| 1174164263 | Tami Anne Miller | Nurse Practitioner | 124 N Bast St, Jackson, MO 63755-1704 | 2019-10-01 |
| 1265080584 | Cameron Nicole Howard | Nurse Practitioner | 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 | 2019-08-29 |
| 1831750843 | Rhiannon Michelle Andresen | Nurse Practitioner | 1022 Greystone Sq, Jackson, TN 38305-3580 | 2019-06-21 |
| 1902376361 | Jenay B Krumm | Nurse Practitioner | 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 | 2018-11-28 |
| Find all providers in JACKSON | ||||
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| 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.