Gabrielle Alexia Bonner

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1694 Torrington CT
Cordova, TN 38016-2332

Phone

(901) 412-8575

NPI assigned

Apr 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Physician Assistant

Education

Southern Illinois University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedar Recovery Center of Middle Tennessee, LLCGroup PAC ID 0446671440, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Cedar Recovery Center of Middle Tennessee, LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Columbia, TN
  • NPI 1801345285
  Medicare reassignment Care Compare group
• Cedar Recovery of Middle Tennessee, LLC

  • Clinic Pharmacy
  • Lebanon, TN
  • NPI 1497458111
  NPD

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

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1497375885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 TORRINGTON CT",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162332",
            "telephone_number": "901-412-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 TORRINGTON CT",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162332",
            "telephone_number": "901-412-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "GABRIELLE",
        "middle_name": "ALEXIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-25",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluff City Laboratory Services
• Michael David Boatright, M.D.
• Lashana Bolden, RN
• Tatyana A Bolshakova-McGehee, PTA
• Naima Bomani, RBT
• Born by Grace
• Amanda Bostick
• Antoinette Boston
• Botts Dental Spa PC
• Jason Bryce Botts, DDS

• Physician Assistant in Cordova, TN
• Providers in Cordova, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; 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.