Daniel Brock Bonner, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN264248 Issued in GA

Practice address

116 Mimosa Dr
Thomasville, GA 31792-6605

Phone

(229) 584-5670

NPI assigned

Aug 24, 2021

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CCSG, IncGroup PAC ID 6103130745, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038
• Grady General Hospital Hospital, Cairo, GA, CCN 110121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CCSG, Inc.

  • Cardiovascular Disease Physician
  • Thomasville, GA
  • NPI 1295120145
  Medicare reassignment Care Compare group NPD
• John D Archbold Memorial Hospital Inc

  dba Archbold Memorial

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Medicare reassignment NPD
• Pathology Associates, P.C.

  • Anatomic Pathology Physician
  • Thomasville, GA
  • NPI 1417910043
  NPD

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

• Grady General Hospital

  • General Acute Care Hospital
  • Cairo, GA
  • NPI 1013961507
  Care Compare affiliation
• John D Archbold Memorial Hospital Inc

  dba Archbold Memorial

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  dba John D. Archbold Memorial Hospital - Rehab

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738
  Care Compare affiliation

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1720755192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 JUNIUS ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317927448",
            "telephone_number": "229-224-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-584-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "DANIEL",
        "middle_name": "BROCK",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN264248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adam Stuart Bozeman, D.M.D,

• Family Nurse Practitioner in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.