Individual provider Active NPI

Bonnie Melissa Cefalu, DVM

  • Veterinarian
  • Jackson, MS
National Provider Identifier
1437475407
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
T1820 Issued in MS
Practice address
4960 Old Canton Rd.
Jackson, MS 39211
Phone
(601) 956-6144
Fax
(601) 956-6145
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X T1820 MS Primary

Addresses

Primary practice location

4960 Old Canton Rd.
Jackson, MS 39211

Mailing address

4960 Old Canton Rd.
Jackson, MS 39211
Phone (601) 956-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T1820MSMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1437475407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 OLD CANTON RD.",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39211",
            "telephone_number": "601-956-6144",
            "fax_number": "601-956-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 OLD CANTON RD.",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39211",
            "telephone_number": "601-956-6144",
            "fax_number": "601-956-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEFALU",
        "first_name": "BONNIE",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "MS",
            "license": "T1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.