Individual provider Active NPI

Bonni S Bishop, PSY.D.

  • Psychologist
  • Lakeland, FL
National Provider Identifier
1881830982
Registry record updated Sep 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY7847 Issued in FL
Practice address
3030 Harden Blvd
Lakeland, FL 33803-7952
Phone
(863) 687-1222
Fax
(863) 603-6546
NPI assigned
Dec 20, 2008
Last updated
Sep 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Psychologist 103T00000X PY7847 FL Primary

Addresses

Primary practice location

3030 Harden Blvd
Lakeland, FL 33803-7952

Mailing address

1324 Lakeland Hills Blvd
Attn: Managed Care Dept
Lakeland, FL 33805-4543
Phone (636) 871-1008

Other practice location 1

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbishop50179@LRHS.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090710000383 FL Practitioner - Clinical Psychologist 1254483902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

3030 Harden Blvd
Lakeland, FL 33803-7952
Phone (863) 284-5000

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3030 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1222

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

Interoperability endpoints

  • Direct secure messaging: bbishop50179@lrhs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1229731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663459200000",
    "number": "1881830982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "ATTN: MANAGED CARE DEPT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "636-871-1008",
            "fax_number": "863-630-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037952",
            "telephone_number": "863-687-1222",
            "fax_number": "863-603-6546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-687-1321",
            "fax_number": "863-603-6534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "BONNI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-20",
        "last_updated": "2022-09-18",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbishop50179@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3030 Harden Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338037952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.