NPIMap

Individual provider Active NPI

Bonna Hardee Gollihugh, APRN

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1558901280
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27020 Issued in TN
Practice address
700 W Forest Ave Ste 400
Jackson, TN 38301-3937
Phone
(731) 541-3310
NPI assigned
Jan 10, 2020
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27020 TN Primary

Addresses

Primary practice location

700 W Forest Ave Ste 400
Jackson, TN 38301-3937

Mailing address

700 W Forest Ave Ste 400
Jackson, TN 38301-3937

Other names 1

  • Bonna Ruth Hardee Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bonna.gollihugh@wth.org Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200413003856 TN Practitioner - Nurse Practitioner 9739519869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

700 W Forest Ave
Jackson, TN 38301-3937

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
27020TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

27 Medical Center Dr
#A
Jackson, TN 38301
Phone (731) 280-0157

620 Skyline Dr
Jackson, TN 38301
Phone (731) 425-5000

700 W Forest Ave
Fl 4
Jackson, TN 38301
Phone (731) 541-2250

700 W Forest Ave
Ste 4
Jackson, TN 38301

Interoperability endpoints

  • Direct secure messaging: bonna.gollihugh@wth.org

Organizations & group practices 2

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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1558901280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE STE 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE STE 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-541-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLIHUGH",
        "first_name": "BONNA",
        "middle_name": "HARDEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bonna.gollihugh@wth.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Work",
            "address_1": "27A Medical Center Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383013949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BONNA",
            "last_name": "HARDEE",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.