Mary Krystin Gillard, FNP-C, RN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11012929 Issued in FL

Practice address

1118 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-7800

Phone

(448) 227-6500

NPI assigned

Dec 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Krystin Bonner Former name

Medicare fee-for-service enrollment

Enrolled in AZ, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Medical Group LLCGroup PAC ID 9638215734, 258 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peoples Home Health LLC Home health agency, Pensacola, FL, CCN 109664
• Baptist Hospital Hospital, Pensacola, FL, CCN 100093
• Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2204/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/15324/brand/1/csg/1/fhir/r4

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.

• Baptist Medical Group LLC

  • Hematology & Oncology Physician
  • Pensacola, FL
  • NPI 1376779892
  Medicare reassignment Care Compare group NPD
• Young Hearts of Yuma, Inc

  • Medical Specialty Clinic/Center
  • Yuma, AZ
  • NPI 1396978268
  Medicare reassignment NPD
• Baptist Medical Group LLC

  • Orthopaedic Surgery Physician
  • Pensacola, FL
  • NPI 1629749692
  NPD
• Saint George Medical Center Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Fort Walton Beach, FL
  • NPI 1184137929
  NPD (past)

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

• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation
• Baptist Health Care, Inc.

  dba Gulf Breeze Hospital

  • General Acute Care Hospital
  • Gulf Breeze, FL
  • NPI 1972664530
  Care Compare affiliation
• Peoples Home Health LLC

  • Home Health Agency
  • Pensacola, FL
  • NPI 1801931837
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1205595733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 GULF BREEZE PKWY STE 102",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617801",
            "telephone_number": "448-227-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617800",
            "telephone_number": "448-227-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "MARY",
        "middle_name": "KRYSTIN",
        "credential": "FNP-C, RN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "267408",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BONNER",
            "middle_name": "KRYSTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• GHM Optical Shop (The Glasses Store)
• Anthony A Giberman, MD
• Jean H Gibson, PH D RN
• Mackenzie Gibson
• Philip Lee Gibson, D.M.D.
• R Chad Gilliland, ATC, MSM, LAT
• Albin McCulla Gilmer, PT
• Tracy Glaze, LMHC
• Elise Glines
• Darby Lynn Godwin, PH.D

• Family Nurse Practitioner in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.