JEREMY BONZO (NPI# 1447511332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447511332 |
| Entity Type | Individual |
| Full Name | JEREMY BONZO |
| Credential | M.D. |
| Practice Address |
336 29th St Ste 101 Ashland KY 41101-1976 |
| Mailing Address |
Po Box 2379 Ashland KY 41105-2379 |
| Practice Telephone | 6063244404 |
| Mailing Telephone | 6064086200 |
| Mailing Fax Number | 6064086612 |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2020-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 50642 | KY | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | MT202082 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100485660 | 05 |
| Street Address |
336 29TH ST STE 101 |
| City | ASHLAND |
| State | KY |
| Zip Code | 41101-1976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972830404 | Kings Daughters Medical Specialties Inc | Internal Medicine | 336 29th St Ste 101, Ashland, KY 41101-1976 | 2009-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588217947 | Aim Wellness LLC | Family Medicine | 844 Central Avenue, Ashland, KY 41101 | 2019-07-24 |
| 1306309067 | Ccc Management, LLC | Durable Medical Equipment & Medical Supplies | 1237 Carter Ave, Ashland, KY 41101 | 2019-04-10 |
| 1366925505 | Samantha Manci | Pharmacist | 2201 Lexington Ashland, Ashalnd, KY 41101 | 2018-09-13 |
| 1174068662 | Lea Ann Reeves-gollihue | Counselor | 1701 Central Ave., Ste. 250, Ashland, KY 41101 | 2016-12-20 |
| 1245786078 | Lindsay Marie Hagerman | Respiratory Therapist, Registered | 2413 Bradley Drive, Ashland, KY 41101 | 2016-08-31 |
| 1033572540 | A Center 4 Change | Psychologist | 5900 Us 60 W, Suite B, Ashland, KY 41101 | 2016-04-01 |
| 1013301159 | Precision Analysis Lab, LLC | Clinical Medical Laboratory | 101 17th Street, Ashland, KY 41101 | 2015-03-26 |
| 1639518574 | Steven Wayne Ledford Jr. | Dentist | 2301 Lexington Ave Ste 120, Ashland, KY 41101 | 2013-06-24 |
| 1528405875 | Brittani Kay Dingess | Pediatrics | 100 Ashland Dr, Ste 102, Ashland, KY 41101 | 2013-05-28 |
| 1770813487 | Paula Jean Hogsten | Clinical Nurse Specialist | 432 - 16th Street, Suite B- Tri State Nephrology, Ashland, KY 41101 | 2009-12-31 |
| Find all providers in zip 41101 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497873657 | Anthony Eugene Way | Urology | 400 Sheridan St, Ashland, OR 97520-1526 | 2007-03-27 |
| 1801859731 | Krishnaswamy Chenroyan Krishnamurthi | Urology | 1941 Baney Road South, Ashland, OH 44805 | 2006-04-11 |
| 1326023110 | Edakkunny W Unnikrishnan | Urology | 900 Saint Christopher Dr, Suite 201, Ashland, KY 41101-7032 | 2005-12-14 |
| 1609863141 | Kenneth N Krutsch | Urology | 2101 Beaser Ave, Annex A, Ashland, WI 54806-3638 | 2005-09-30 |
| 1477550416 | William Charles Thorndyke | Urology | 336 29th St, Ashland, KY 41101-1900 | 2005-07-06 |
| 1285916916 | Kings Daughters Medical Specialties Inc. | Urology | 2245 Winchester Ave Ste 1, Ashland, KY 41101-7848 | 2011-09-20 |
| 1013182443 | Justin Kevin Dixon | Urology | 336 29th St, Ashland, KY 41101-1900 | 2008-04-27 |
| 1679764534 | Brian Philip Defade | Urology | 1101 Saint Christopher Dr, Ashland, KY 41101-7087 | 2007-08-06 |
| 1194945956 | E.w. Unnikrishnan M.d. Psc | Urology | 900 Saint Christopher Dr, Suite 201, Ashland, KY 41101-7090 | 2007-04-26 |
| 1891895538 | John W Peck II | Urology | 2212 Mifflin Ave, Suite 130, Ashland, OH 44805-8848 | 2006-09-23 |
| Find all providers in ASHLAND | ||||
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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.