Individual provider Active NPI

Loida E. Bonney, M.D.

  • Internal Medicine Physician
  • Fayetteville, GA
National Provider Identifier
1316998982
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
59375 Issued in GA
Practice address
745 Glynn St S
Fayetteville, GA 30214-2049
Phone
(770) 719-5490
Fax
(770) 719-3113
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 59375 GA Primary

Addresses

Primary practice location

745 Glynn St S
Fayetteville, GA 30214-2049

Mailing address

1267 Highway 54 W
Fayetteville, GA 30214-2114
Phone (770) 719-5601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070627000066 GA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6305862665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

730 Glynn St S
Fayetteville, GA 30214-2050
Phone (770) 460-3650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59375GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Jul 11, 2016 Accepting new patients
Alpha Internal Medicine, LLC Internal Medicine CurrentSince May 1, 2013 Accepting new patients
Piedmont Providers LLC Internal Medicine Past Accepting new patients
Piedmont Cardiology of Atlanta, LLC Past Accepting new patients
Healthquest Chiropractic of Georgia PastSince Jun 10, 2012 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

745 Glynn St S
Fayetteville, GA 30214
Phone (770) 599-1010

1401 Georgian Park
Ste 200
Peachtree City, GA 30269
Phone (770) 632-8909

1975 Highway 54 W
Ste 150
Peachtree City, GA 30269
Phone (770) 486-5000

Organizations & group practices 6

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1316998982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142114",
            "telephone_number": "770-719-5601",
            "fax_number": "678-817-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 GLYNN ST S",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142049",
            "telephone_number": "770-719-5490",
            "fax_number": "770-719-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEY",
        "first_name": "LOIDA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "59375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.