Individual provider Active NPI

Iliana Berenice Bonilla Canas, DNP, FNP, AGACNP

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1720849474
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
226558 Issued in AR
Practice address
9600 Baptist Health Dr Ste 320
Little Rock, AR 72205-6322
Phone
(501) 227-0421
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 226558 AR
Family Nurse Practitioner 363LF0000X 226558 AR Primary

Addresses

Primary practice location

9600 Baptist Health Dr Ste 320
Little Rock, AR 72205-6322

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 227-0421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20240220000953 AR Practitioner - Nurse Practitioner 6204270127 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226558ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Jan 21, 2024 Accepting new patients

Locations

6020 Warden Rd
Ste 100
Sherwood, AR 72120
Phone (501) 552-6400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1720849474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-227-0421",
            "fax_number": "501-227-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BAPTIST HEALTH DR STE 320",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056322",
            "telephone_number": "501-227-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA CANAS",
        "first_name": "ILIANA",
        "middle_name": "BERENICE",
        "credential": "DNP, FNP, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "226558",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "226558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.