BREANNA L BONNER FNP
NPI 1700125895
Nurse Practitioner - Family in Ellisville, MS
About Breanna L Bonner Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BREANNA L BONNER FNP (NPI 1700125895) is an individual family provider in Ellisville, Mississippi, licensed in Mississippi (R867420) and active in the NPI registry since February 2013. She is enrolled in Medicare PECOS, is affiliated with South Central Reg Med Ctr, and is a graduate of Other (2012).
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
Breanna L Bonner Fnp 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 Reassignments
2Medicare enrollment records show Breanna Bonner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Petal, MS 39465
- Reassigned Medicare billing, Mississippi enrollment
- 38 clinicians in this Medicare group
Hattiesburg, MS 39401
- Reassigned Medicare billing, Mississippi enrollment
- 48 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
South Central Reg Med Ctr
Acute Care Hospitals · Laurel, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39437 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 13
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Breanna Bonner's NPI number?
The NPI number for Breanna Bonner is 1700125895. It was assigned to this individual provider in the NPPES registry on February 8, 2013.
Where is Breanna Bonner located?
Breanna Bonner practices at 1101 Highway 11 S, Ellisville, MS 39437. The listed phone number is (601) 477-5771.
What is Breanna Bonner's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Breanna Bonner enrolled in Medicare?
Yes. Breanna Bonner 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 organizations bill Medicare for Breanna Bonner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Breanna Bonner reassigns Medicare benefits to 2 organizations: Petal Urgent Care LLC (Petal, MS) and Hattiesburg Urgent Care, LLC (Hattiesburg, MS). Each 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 Breanna Bonner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Breanna Bonner accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Breanna Bonner 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.
Is Breanna Bonner affiliated with any hospitals?
According to CMS data, Breanna Bonner is affiliated with South Central Reg Med Ctr.
When was this NPI record last updated?
The NPPES record for Breanna Bonner was last updated on December 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Breanna L Bonner, FNP · NPI 1700125895
Family physician in Ellisville, Mississippi. Individual provider, active in the CMS NPPES registry since February 8, 2013.
## Identity
- **NPI:** 1700125895 (Entity type: Individual)
- **Enumerated:** February 8, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** R867420 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1101 HIGHWAY 11 S, Ellisville, MS 39437-4443
- **Phone:** (601) 477-5771
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Petal Urgent Care LLC (NPI 1982908877, Petal, MS); Hattiesburg Urgent Care, LLC (NPI 1164805156, Hattiesburg, MS) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** December 27, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1700125895) · Data from the CMS NPPES public registry.