ALBERT J BONEBRAKE (NPI# 1881636090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881636090 |
| Entity Type | Individual |
| Full Name | ALBERT J BONEBRAKE |
| Credential | MD |
| Practice Address |
1001 E Primrose St Springfield MO 65807-5155 |
| Mailing Address |
Po Box 9007 Springfield MO 65808-9007 |
| Practice Telephone | 4178753000 |
| Practice Fax Number | 4178753450 |
| Mailing Telephone | 4178753000 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2012-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
35473 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD | 18053 | 01 | |
| MO | 200249522 | 05 |
| Street Address |
1001 E PRIMROSE ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915792 | Robert Clayton Scanlon II | Urology | 1001 E Primrose St, Springfield, MO 65807-5155 | 2005-07-07 |
| 1619580537 | Nathaniel Levi Kenady | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2020-08-29 |
| 1891343893 | Connie J Garrett | Dietitian, Registered | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-09-03 |
| 1689236085 | Lindsey Joy Gelber | Dietitian, Registered | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-07-05 |
| 1174186654 | Stephenie Michele Zinter | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-04-19 |
| 1215495650 | Mikel Dashtipour | Physician Assistant | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-03-05 |
| 1043774789 | Arielle M Campbell | Physician Assistant | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-01-28 |
| 1649755919 | Stephanie Lynn Brown | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-10-02 |
| 1114401312 | Teresa Cunningham | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-09-24 |
| 1336629120 | Katelynne D Haun | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912347519 | Erica Weston | Obstetrics & Gynecology | 3300 Main St, Springfield, MA 01107-1112 | 2013-06-27 |
| 1376803148 | Lindsay Morgan West | Obstetrics & Gynecology | 3300 Main Street, 4th Floor, Springfield, MA 01107-1112 | 2012-05-25 |
| 1043338395 | Nora Taylor Maczura | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2007-03-26 |
| 1902931587 | Kathleen Ying Yang | Obstetrics & Gynecology | 3377 Riverbend Dr Ste 500, Springfield, OR 97477-8802 | 2007-02-22 |
| 1902990260 | John C. Shaffer | Obstetrics & Gynecology | 800 N. 1st Street, Springfield, IL 62702 | 2006-10-03 |
| 1598859324 | Michel Prefontaine | Obstetrics & Gynecology | 3350 Main St, Springfield, MA 01199-1005 | 2006-10-03 |
| 1194835181 | Jay W Carlson | Obstetrics & Gynecology | 2055 S Fremont Ave, Ste 200, Springfield, MO 65804-2206 | 2006-08-30 |
| 1821103912 | Tashanna K Myers | Obstetrics & Gynecology | 3350 Main St, 4th Fl, Springfield, MA 01107-1112 | 2006-08-20 |
| 1063437127 | Audrey Garrett | Obstetrics & Gynecology | 3355 Riverbend Dr, Ste 210, Springfield, OR 97477-8800 | 2006-07-12 |
| 1740212232 | Deborah J Dotters | Obstetrics & Gynecology | 3355 Riverbend Dr, Ste 210, Springfield, OR 97477-8800 | 2006-07-07 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.