Jessica Bonilla, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

GAA-NP001609 Issued in GA

Practice address

11459 Johns Creek Pkwy
Johns Creek, GA 30097-3515

Phone

(770) 497-1555

NPI assigned

Jan 17, 2023

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 GA

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  Family, GA

  Medicare reassignment Care Compare group NPD
• Nursing Home Physician Group PLLC

  • Physical Medicine & Rehabilitation Physician
  • Warrenville, IL
  • NPI 1417703844
  NPD (past)

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1922713676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11459 JOHNS CREEK PKWY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300973515",
            "telephone_number": "770-497-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11459 JOHNS CREEK PKWY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300973515",
            "telephone_number": "770-497-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "GAA-NP001609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body-N-Balance
• Shae Boguslawski
• Teesia Lynn Bolar-Dixon
• Bon Health Clinic L.L.C.
• Paola Bonaccorsi, MD
• Cassandre Bosse
• William Bowen, PHARM.D.
• Susan Lynn Bower, M.D.
• Meagan Lee Brady, DNP, AGACNP-BC
• Brainstem Solutions

• Primary Care Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.