Bonita H Dyess, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

013370 Issued in LA

Practice address

3401 Magnolia CV
Monroe, LA 71203-2375

Phone

(318) 325-6311

Fax

(318) 361-9805

NPI assigned

Aug 26, 2005

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdyess16364@direct.casso.us.com

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.

• Affinity Health Group, LLC

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1023291226

  Pediatrics

  Medicare reassignment NPD
• St Francis Medical Group LLC

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1134405087
  Medicare reassignment NPD
• Affinity Health Group, LLC

  • Orthopaedic Surgery Physician
  • Monroe, LA
  • NPI 1861879249
  NPD
• St Francis Medical Center, Inc

  • Rehabilitation Hospital Unit
  • Monroe, LA
  • NPI 1013906239
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1902899602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD STE 355",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MAGNOLIA CV",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032375",
            "telephone_number": "318-325-6311",
            "fax_number": "318-361-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYESS",
        "first_name": "BONITA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "013370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1304875",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dva Renal Healthcare Inc
• Dva Renal Healthcare Inc
• Courtney Dye, PT, DPT
• Maurice Parnell Dyer Sr.
• Whitney Dyer
• Dynamic Therapy Solutions, LLC
• E.a. Conway Medical Center
• E.a. Conway Medical Center
• E.a.Conway Medical Staff Group
• Eagles Wings Recovery

• Pediatrics Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.