Kimberly Ann Bonvillian, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

343191 Issued in LA

Practice address

2750 Gause Blvd E
Slidell, LA 70461-4149

Phone

(985) 639-3777

Fax

(985) 639-3725

NPI assigned

Mar 6, 2024

Last updated

Sep 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Belle Chasse Physician Services LLCGroup PAC ID 9335379379, 258 clinicians

Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
• Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbonvillian2303498@direct.ochsner.org

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.

• Belle Chasse Physician Services LLC

  • Hospitalist Physician
  • Terrytown, LA
  • NPI 1245653237

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment Care Compare group NPD (past)
• Ochsner Clinic LLC

  dba Diabetes Prevention Program

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  dba Ochsner Health Center - Slidell West

  • General Practice Physician
  • Slidell, LA
  • NPI 1982832556
  NPD

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

• Ochsner Clinic Foundation

  dba Ochsner Medical Center Acute

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1811973100
  Care Compare affiliation
• Slidell Memorial Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1578568481
  Care Compare affiliation

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1871350702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614149",
            "telephone_number": "985-639-3777",
            "fax_number": "985-639-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVILLIAN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "343191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chuan D Bolden, PHARMD
• Crispin G. Bolisay, MD
• Sabyne H Bonnecarrere, LPC
• Uaketha Bonner
• Scott E Bonson, D.D.S.
• Riana Brielle Booker
• Beverly Hall Borchers
• Lauren Born
• Sidney Borne
• Joseph B. Boucree Jr., M.D.

• Physician Assistant in Slidell, LA
• Providers in Slidell, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.