Bonnie A Kidd, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2021031499 Issued in TN

Practice address

7345 Courage Way
Chattanooga, TN 37421-1555

Phone

(423) 602-9797

NPI assigned

May 20, 2021

Sex

Female

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 TN

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

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 and National Provider Directory roles.

• Erlanger Behavioral Health, LLC

  • Psychiatric Hospital
  • Chattanooga, TN
  • NPI 1306354790
  Medicare reassignment NPD
• Scenic City Alliance of Psychiatry and Psychotherapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
  • NPI 1144788753
  Medicare reassignment NPD

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1861067183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 COURAGE WAY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211555",
            "telephone_number": "423-602-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 COURAGE WAY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211555",
            "telephone_number": "423-602-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "BONNIE",
        "middle_name": "A",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "2021031499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Khan, RPH
• Pooja Khariwal
• Heidi Khatibi, LPC-MHSP
• Michelle Nilufar Khoshkhou, PMHNP-BC
• Christi S. Kicklighter, CRNA
• Joseph A. Kidd, D.O.
• Kidney Center of Highway 58, LLC
• Kidney Center of Missionary Ridge, LLC
• Robin Patrice Kilby
• Jason Kile, NP-C

• Psychiatric/Mental Health Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.