Bonita L Brockman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

045410 Issued in GA

Practice address

2041 Mesa Valley Way
Ste 185
Austell, GA 30106

Phone

(404) 785-8900

Fax

(404) 785-8948

NPI assigned

Jun 8, 2006

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 names 1

• Evan Lavonne Brockman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bonita.brockman.1@27415.direct.athenahealth.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.

• Michelle Zeanah MD PC

  • Medical Specialty Clinic/Center
  • Statesboro, GA
  • NPI 1760981609
  NPD (past)
• Wellstar Health System, Inc.

  • Point of Service
  • Marietta, GA
  • NPI 1437219656

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962443515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 NELMS AVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30307",
            "telephone_number": "404-822-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MESA VALLEY WAY",
            "address_2": "STE 185",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "404-785-8900",
            "fax_number": "404-785-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "BONITA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "045410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVAN",
            "last_name": "BROCKMAN",
            "middle_name": "LAVONNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Keith Braswell, D.C .
• Brighter Days Homecare Agency
• Pavel Britkin, MD
• Julius Britt Jr., CST
• Brittany Carter LCSW LLC
• Ashley Brooks, PA-C
• Bridgette Jones Brooks, DMD
• D Hodari Brooks, M.D
• Cyanna Broughton
• Clairice Brown-Allen

• Pediatrics Physician in Austell, GA
• Providers in Austell, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.