Kami Bonner Pugh, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN138402 Issued in GA

Practice address

3720 Davinci CT
Suite 400
Norcross, GA 30092-7627

Phone

(770) 300-3555

NPI assigned

Mar 26, 2014

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 identifiers 2

Other names 1

• Kami Bonner Pugh Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Primary Care of Georgia LLCGroup PAC ID 0648421065, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Gray, GA
  • NPI 1336492511

  GA

  Medicare reassignment Care Compare group NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA, Nurse Practitioner

  Medicare reassignment NPD
• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951
  NPD
• Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Macon, GA
  • NPI 1447501689
  NPD (past)
• Synergetic Healings LLC

  • Clinical Social Worker
  • Gray, GA
  • NPI 1831967884
  NPD (past)

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1477970549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 DAVINCI CT",
            "address_2": "SUITE 400",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300927627",
            "telephone_number": "770-300-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 DAVINCI CT",
            "address_2": "SUITE 400",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300927627",
            "telephone_number": "770-300-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "KAMI",
        "middle_name": "BONNER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN138402",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN138402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCO AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "NCO-000001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE -- NP LICENSE",
            "identifier": "RN138402",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMI",
            "last_name": "PUGH",
            "middle_name": "BONNER",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Adult Health Nurse Practitioner in Norcross, GA
• Providers in Norcross, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.