MCKENZIE BONIFIELD
NPI 1205411204
Nurse Practitioner - Family in Carbondale, IL
About Mckenzie Bonifield NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MCKENZIE BONIFIELD (NPI 1205411204) is an individual family provider in Carbondale, Illinois, licensed in Illinois (209022703) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mckenzie Bonifield is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Mckenzie Bonifield reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Carbondale, IL 62901
- Reassigned Medicare billing, Illinois enrollment
- 52 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CARBONDALE, IL 62901
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mckenzie Bonifield's NPI number?
The NPI number for Mckenzie Bonifield is 1205411204. It was assigned to this individual provider in the NPPES registry on March 11, 2021.
Where is Mckenzie Bonifield located?
Mckenzie Bonifield practices at 400 S Lewis Ln, Carbondale, IL 62901. The listed phone number is (618) 519-9200.
What is Mckenzie Bonifield's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mckenzie Bonifield enrolled in Medicare?
Yes. Mckenzie Bonifield is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mckenzie Bonifield's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mckenzie Bonifield reassigns Medicare benefits to Shawnee Health Service And Development Corp (Carbondale, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mckenzie Bonifield's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mckenzie Bonifield accept?
Health plans from UnitedHealthcare list Mckenzie Bonifield as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mckenzie Bonifield was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mckenzie Bonifield · NPI 1205411204
Family physician in Carbondale, Illinois. Individual provider, active in the CMS NPPES registry since March 11, 2021.
## Identity
- **NPI:** 1205411204 (Entity type: Individual)
- **Enumerated:** March 11, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209022703 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 400 S LEWIS LN, Carbondale, IL 62901-3547
- **Phone:** (618) 519-9200
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Shawnee Health Service And Development Corp (NPI 1073745345, Carbondale, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** March 17, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1205411204) · Data from the CMS NPPES public registry.