David Edward Bonnin, MD
Individual provider Active NPI Internal Medicine Physician · Fort Eisenhower, GA
NPI 1770143067 · NPPES record last updated Feb 14, 2025
Key facts
- NPI
- 1770143067
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0101275351 (VA)
- Practice address
- D.D. Eisenhower Army Medical Center
300 E. Hospital Road
Fort Eisenhower, GA 30805 - Phone
- (706) 787-6945
- Fax
- (706) 787-0304
- NPI assigned
- Jun 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- New York Medical College, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Georgialina Physical Therapy Associates LLC
Practice addresses (Care Compare)
1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810
Hospital & facility affiliations
- Centerwell Home Health
- Trinity Home Health
- Enhabit Home Health
- Amedisys Home Health Care
- Wellstar MCG Health, Affiliated With Med Col
- Doctors Hospital
- Piedmont Augusta Hospital
- Aiken Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250710000119 | VA | Practitioner - Internal Medicine | 8628304854 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD210002478 | DC | MD | Internal Medicine Physician |
| D0094575 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Internal Medicine | Current |
Accepting new patients |
Locations
4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532
2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852
14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000
13285 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 986-2400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2019019484 | MO | |
| Internal Medicine Physician | 207R00000X | MD210002478 | DC | |
| Internal Medicine Physician | 207R00000X | D0094575 | MD | |
| Internal Medicine Physician | 207R00000X | 0101275351 | VA | Yes |
Addresses
Primary practice location
D.D. Eisenhower Army Medical Center
300 E. Hospital Road
Fort Eisenhower, GA 30805
Mailing address
655 Watkins Mill Rd FL 5
Gaithersburg, MD 20879-3301
Other practice location 1
655 Watkins Mill Rd Fl 5
Gaithersburg, MD 20879-3301
Phone (240) 813-8740
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Fort Eisenhower, GA
- Kimberley Yvonne Banta
- Glenn Ivan Bascon
- Ryan Hartwell Becker
- Michael Donald Beres
- Spencer Blankenship
- Benjamin Brainerd
- Kerrianne Bresnan
- Mitchell York Brown
- Leslee Nichole Browning
- Lauren Geeter Bursey
All providers in Fort Eisenhower, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.