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Fawn Boonstra , RD

Dietitian, Registered β€’ Apache Junction, AZ

Active NPI 1902359771 Individual Practitioner Female Practitioner
Practice location in NPPES

99 S. Gold Dr. Suite 5, Goldfield Cardiovascular Institute
Apache Junction, AZ 85120

Call 4809620101 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

99 S. Gold Dr. Suite 5
Goldfield Cardiovascular Institute

Apache Junction, AZ 85120

Telephone 4809620101
Organization at the Same NPPES Address or Phone
Goldfield Medical Clinics, Llc Facility NPI 1861412686

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Apache Junction and Arizona

2 active clinicians are listed under Dietitian, Registered with a practice address in Apache Junction, AZ (1,435 in Arizona).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-06-24
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Arizona Medical Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Emily Hubner , RDN

Dietitian, Registered

NPI 1013518943

Registered Dietitian Nutritionist

Dr. Shantha Kumar , MD

Internal Medicine - Cardiovascular Disease

NPI 1396768958

Doctor of Medicine (M.D.)

Shiny Thomas , NP

Family Medicine - Adult Medicine

NPI 1558916247

Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Business Mailing Address June 24, 2020

Registered at 771 S CORNWALL DR, APACHE JUNCTION, AZ 851204812 (Tel: 6022062017)

βœ…
NPI Profile Active July 28, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 28, 2016

Registered at 99 S. GOLD DR. SUITE 5, GOLDFIELD CARDIOVASCULAR INSTITUTE, APACHE JUNCTION, AZ 85120 (Tel: 4809620101)

πŸ“
Business Mailing Address (Initial Record) July 28, 2016

Registered at 1357 N THUNDERBIRD CT, GILBERT, AZ 852341503 (Tel: 4802867907)

πŸ‘€
Provider Name / Credentials (Initial Record) July 28, 2016

Recorded as FAWN BOONSTRA, RD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2016

Dietitian, Registered

🟒
Initial NPI Registration & Enumeration July 28, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1902359771
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2016
Last Update: June 24, 2020
Sole Proprietor: Yes

Mailing Address

771 S Cornwall Dr

Apache Junction, AZ 851204812

Phone: 6022062017

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.