Active NPI
Bonnie P Carminati, FNP
- Nurse Practitioner
- Jackson, MS
National Provider Identifier
1801816988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R748964
- Practice address
- 2500 North State Street
Department of Medicine/Division of General Internal Med
Jackson, MS 39216-4500 - Phone
- (601) 984-5660
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R748964 | MS | |
| Nurse Practitioner | 363L00000X | R748964 | MS | Primary |
Addresses
Primary practice location
2500 North State Street
Department of Medicine/Division of General Internal Med
Jackson, MS 39216-4500
Mailing address
2500 North State Street
Dept of General Internal Medicine
Jackson, MS 39216-4500
Phone (601) 984-5660
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01233201 | Other | MS | RAILROAD MEDICARE |
| RR P00252348 | Other | MS | RAILROAD |
| 1652687 | Medicaid | LA | |
| 00122313 | Medicaid | MS | |
| P00462165 | Other | MS | RAILROAD MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Internal Medicine Assoc LLP | Internal Medicine | Past | Accepting new patients |
| University Family Medicine Associates, PLLC | Past | Accepting new patients |
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.
-
- Clinic/Center
- Jackson, MS
- NPI 1396846648
-
- Internal Medicine Physician
- Jackson, MS
- NPI 1083656870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397001600000",
"number": "1801816988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 NORTH STATE STREET",
"address_2": "DEPT OF GENERAL INTERNAL MEDICINE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5660",
"fax_number": "601-984-6870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NORTH STATE STREET",
"address_2": "DEPARTMENT OF MEDICINE/DIVISION OF GENERAL INTERNAL MED",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMINATI",
"first_name": "BONNIE",
"middle_name": "P",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2014-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "R748964",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R748964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01233201",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "RR P00252348",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1652687",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00122313",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00462165",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.