NPIMap

Individual provider Active NPI

Madeline Taylor Bonnette, PA-C

  • Physician Assistant
  • Alexandria, LA
National Provider Identifier
1124538368
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
307188 Issued in LA
Practice address
3802 Prescott Rd
Alexandria, LA 71301-3731
Phone
(318) 487-6060
Fax
(318) 487-0406
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 307188 LA Primary

Addresses

Primary practice location

3802 Prescott Rd
Alexandria, LA 71301-3731

Mailing address

3802 Prescott Rd
Alexandria, LA 71301-3731
Phone (318) 487-6060

Other names 1

  • Madeline Mackenzi Taylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171108003538 LA Practitioner - Physician Assistant 5496011363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic Texas 1,540 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

3802 Prescott Rd
Alexandria, LA 71301-3731
Phone (318) 487-6060

Hospital & facility affiliations

  • Elara Caring Home health agency, Alexandria, LA, CCN 197643
  • Christus St Frances Cabrini Hospital Hospital, Alexandria, LA, CCN 190019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network CurrentSince Jul 20, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network Physician Assistant CurrentSince Jul 20, 2020 Accepting new patients

Locations

3802 Prescott Rd
Alexandria, LA 71301
Phone (318) 487-6060

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: mtaylor219951@christushealth.direct-ci.net

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1124538368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 PRESCOTT RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013731",
            "telephone_number": "318-487-6060",
            "fax_number": "318-487-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 PRESCOTT RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013731",
            "telephone_number": "318-487-6060",
            "fax_number": "318-487-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNETTE",
        "first_name": "MADELINE",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "307188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "TAYLOR",
            "middle_name": "MACKENZI",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.