BETHANN BONNER (NPI# 1811946320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811946320 |
| Entity Type | Individual |
| Full Name | BETHANN BONNER |
| Credential | M.D. |
| Practice Address |
1500 Associates Dr Dubuque IA 52002-2201 |
| Practice Telephone | 5635844440 |
| Practice Fax Number | 5635844295 |
| Mailing Telephone | 5635844100 |
| Mailing Fax Number | 5635844110 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2009-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 25904 | WI | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 29141 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0094193 | 05 |
| Street Address |
1500 ASSOCIATES DR |
| City | DUBUQUE |
| State | IA |
| Zip Code | 52002-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530271 | Tri-state Surgery Center, L.L.C. | Clinic/Center | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2005-07-05 |
| 1235757261 | Emily Burgmeier May | Nurse Practitioner | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2020-07-07 |
| 1104451673 | Emily Claire Kuhl | Occupational Therapist | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2020-03-05 |
| 1679105449 | Chelsea Leah Berry | Physician Assistant | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2020-02-10 |
| 1689212227 | Toni Marie Monat | Physical Therapist | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2019-12-13 |
| 1457905424 | Sara Elizabeth Croghan | Physical Therapist | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2019-07-29 |
| 1104356997 | Matthew Keith Kraciun | Family Medicine | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2017-06-14 |
| 1558890202 | Kristen Celeste Anderson | Pediatrics | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2017-06-07 |
| 1194279117 | Brittany Gosse | Physical Therapist | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2016-08-08 |
| 1205280468 | Naomi Hasselblad | Internal Medicine | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2016-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144725193 | Rebecca Marie Fitzpatrick | Pharmacist | 7425 Chavenelle Rd Ste 300, Dubuque, IA 52002 | 2018-03-29 |
| 1598020943 | Steven Matthew Leifker | Dentist | 1645 John F. Kennedy Rd, Dubuque, IA 52002 | 2012-07-11 |
| 1922364280 | Susan A Neuser | Pharmacist | 74 25 Chavenelle Rd, Dubuque, IA 52002 | 2012-04-11 |
| 1720308240 | Yakov S Zagalskiy | Family Medicine | 1500 Associates Drive, Dubuque, IA 52002 | 2010-06-07 |
| 1689904690 | Meryl Rae Welsh | Counselor | 2255 Jkf Road, Dubuque, IA 52002 | 2010-01-14 |
| 1982864047 | Joel Gregory Thielen | Acupuncturist | 1880 Radford Road, Dubuque, IA 52002 | 2008-06-12 |
| 1609052323 | Jason E Meyer Physical Therapy PC | Clinic/Center | 2300 John F Kennedy Rd, Dubuque, IA 52002 | 2008-01-11 |
| 1508053828 | Assisted Living Concepts Inc | Assisted Living Facility | 2700 Matthew John Drive, Dubuque, IA 52002 | 2007-10-01 |
| 1588863252 | Miracle Ear | Audiologist-Hearing Aid Fitter | 555 Jf Kennedy Road, Dubuque, IA 52002 | 2007-07-13 |
| 1639383599 | Michelle Ann Gardner | Optometrist | 808 Wacker Dr, Dubuque, IA 52002 | 2007-05-10 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497846679 | James L. Livermore | Pediatrics | 1789 Elm St, Suite A, Dubuque, IA 52001-2256 | 2006-09-27 |
| 1346288073 | Shiny Susan Kunjummen | Pediatrics | 1500 Delhi St Ste 3500, Dubuque, IA 52001-6321 | 2006-06-03 |
| 1558890202 | Kristen Celeste Anderson | Pediatrics | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2017-06-07 |
| 1689109969 | Meghan Wendland | Pediatrics | 1000 Langworthy St, Dubuque, IA 52001-7365 | 2017-04-25 |
| 1609240282 | The Finley Hospital | Pediatrics | 1500 Delhi St, Suite 3500, Dubuque, IA 52001-6358 | 2015-11-19 |
| 1356720882 | Marissa Michel | Pediatrics | 1500 Delhi St Ste 3500, Dubuque, IA 52001 | 2015-05-29 |
| 1851704480 | John Michael Callahan | Pediatrics | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2014-06-11 |
| 1962675264 | Jamie Jo Quintana | Pediatrics | 1500 Delhi St, Suite 3500, Dubuque, IA 52001-6321 | 2008-04-08 |
| 1528262136 | Thomas Eldon Callahan | Pediatrics | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2007-06-14 |
| 1346294634 | Donald Harvey Reyerson | Pediatrics | 1500 Associates Dr, Dubuque, IA 52002-2201 | 2006-05-20 |
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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.