CRIS H BONTRAGER (NPI# 1811909013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811909013 |
| Entity Type | Individual |
| Full Name | CRIS H BONTRAGER |
| Credential | D.O. |
| Practice Address |
220 Hospital Dr Jackson AL 36545-2459 |
| Mailing Address |
112 Forest Ave Jackson AL 36545-2714 |
| Practice Telephone | 2512469021 |
| Practice Fax Number | 2512461122 |
| Mailing Telephone | 2512465114 |
| Mailing Fax Number | 2512469553 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | DO-902 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS BLUE SHIELD | 515-29212 | 01 |
| 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 |
| 1164837563 | Rene Bontrager | Nurse Practitioner | 220 Hospital Dr, Jackson, AL 36545-2459 | 2014-06-24 |
| 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 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851731103 | Zachary James Virgin | Surgery | 300 W Washington Ave Ste 300, Jackson, MI 49201-2160 | 2013-07-01 |
| 1407290372 | Derek S. Palmer | Surgery | 120 District Blvd Apt 433, Jackson, MS 39211-6389 | 2013-04-23 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1639419997 | Fred Silvestri Md, LLC | Surgery | 4 Long Bay Rd, Jackson, NJ 08527-2662 | 2013-02-25 |
| 1528356482 | James P. Spell | Surgery | 21 Lamplighter Rd., Jackson, MS 39208 | 2011-07-13 |
| 1629371018 | Richard L Yelverton Md Pa | Surgery | 1040 River Oaks Dr Ste 102, Jackson, MS 39232-9539 | 2010-12-07 |
| 1619125952 | Otha Edward Williams Jr. | Surgery | 1736 Lake Trace Dr, Jackson, MS 39211-3353 | 2008-08-28 |
| 1770604803 | Rajesh Kuruba | Surgery | 1500 E Woodrow Wilson Ave., Jackson, MS 39216-5199 | 2007-04-03 |
| 1679692396 | Reginald Willis Martin | Surgery | 971 Lakeland Dr Ste 211, Jackson, MS 39216-4607 | 2007-03-28 |
| 1295878783 | P George Poore | Surgery | 555 East Broadway Ste 212, Jackson, WY 83001-4777 | 2007-02-14 |
| 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.