OTTO JOSEPH BONIN JR. (NPI# 1558368316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558368316 |
| Entity Type | Individual |
| Full Name | OTTO JOSEPH BONIN JR. |
| Credential | NP |
| Practice Address |
1215 Independence Blvd 1a Zachary LA 70791-7391 |
| Practice Telephone | 2255702010 |
| Practice Fax Number | 2255708573 |
| Mailing Telephone | 2255702010 |
| Mailing Fax Number | 2255708573 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN085359 - AP044 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1069311 | 05 | |
| LA | RR MEDICARE | P00089352 | 01 |
| Street Address |
1215 INDEPENDENCE BLVD 1A |
| City | ZACHARY |
| State | LA |
| Zip Code | 70791-7391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164054110 | Amandalin Hopkins Whittington | Occupational Therapist | 4555 Bert St, Zachary, LA 70791 | 2020-02-07 |
| 1346883352 | Dr Terrell S Manuel LLC | Nurse Practitioner | 12038 Greenwell Springs/port Hudson Road, Zachary, LA 70791 | 2019-10-22 |
| 1902451131 | Edward Williams | Case Manager/Care Coordinator | 22749 Fairvway View Drive, Zachary, LA 70791 | 2019-08-05 |
| 1275090672 | Ashley Talbot Thompson | Nurse Practitioner | 5645 Newell St, Zachary, LA 70791 | 2019-02-22 |
| 1659867265 | American Oncology Partners, P.a. | Internal Medicine | 1673 E Mount Pleasant Rd Unit F102, Zachary, LA 70791 | 2018-07-06 |
| 1629574447 | Darren Keith Ryland | Massage Therapist | 5037 Main St, Suite B, Zachary, LA 70791 | 2018-04-02 |
| 1306355102 | Radiation Oncology Center - Zachary | Clinic/Center | 6180 Main Street, Ste B, Zachary, LA 70791 | 2017-09-25 |
| 1861913568 | Sylvia Simone Henderson | Case Manager/Care Coordinator | 8932 Highland Oaks Ave, Zachary, LA 70791 | 2017-07-03 |
| 1346770674 | Gaylian Anthony White | Counselor | 20051 Old Senic Hwy, Apt 2605, Zachary, LA 70791 | 2017-06-19 |
| 1104353218 | Jessica Rene Griffin | Counselor | 6676 Lakeridge Drive, Zachary, LA 70791 | 2017-05-19 |
| Find all providers in zip 70791 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366850513 | Jacie Bergeron | Nurse Practitioner | 14325 Milldale Rd, Zachary, LA 70791-8040 | 2014-07-31 |
| 1497112742 | Christopher David Dedon | Nurse Practitioner | 4801 Mchugh Rd, Suite C, Zachary, LA 70791-5364 | 2016-01-18 |
| 1639549371 | Crystal Hurst | Nurse Practitioner | 6550 Main St, Ste. 1000, Zachary, LA 70791-4092 | 2015-10-06 |
| 1629451596 | Joseph Daniel Williams | Nurse Practitioner | 6550 Main St, Suite 1000, Zachary, LA 70791-4092 | 2015-07-09 |
| 1497019376 | Amy Baum Tomb | Nurse Practitioner | 6550 Main St, Ste. 1000, Zachary, LA 70791-4092 | 2012-06-26 |
| 1942502323 | Mecca Hunter Daigre | Nurse Practitioner | 6550 Main St, Suite 1000, Zachary, LA 70791-4072 | 2010-11-17 |
| 1003146226 | Dustin Allen Logue | Nurse Practitioner | 6550 Main St, Zachary, LA 70791-4072 | 2010-01-11 |
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|---|---|---|---|---|
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| 1972117455 | Erin Mccabe | Nurse Practitioner | 3712 Tartan Dr, Metairie, LA 70003-1640 | 2020-09-02 |
| 1023620259 | Caroline Hebert | Nurse Practitioner | 1297 Saint Charles St Ste H, Houma, LA 70360-2869 | 2020-08-19 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1124638036 | Kimberly Roshelle Coney | Nurse Practitioner | 62112 Bennett Rd, Roseland, LA 70456-1706 | 2020-08-05 |
| 1356951396 | Advance Clinical Associates LLC | Nurse Practitioner | 2505 Cypress Springs Ave, Ruston, LA 71270-5109 | 2020-08-05 |
| 1487264594 | Neely Primary | Nurse Practitioner | 102 Independence Blvd, Lafayette, LA 70506-6085 | 2020-08-04 |
| 1225648629 | Indria Kendrick | Nurse Practitioner | 62 Creduer Rd, Pineville, LA 71360-9165 | 2020-07-31 |
| 1770192171 | Celeste Woodard Brown | Nurse Practitioner | 751 Bayou Pines East Dr Ste L, Lake Charles, LA 70601-7196 | 2020-07-31 |
| 1306455498 | Headache Center Nola, LLC | Nurse Practitioner | 2221 Clearview Pkwy Ste 203, Metairie, LA 70001-2497 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
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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.