Bonita Emergency Group, LLC
Emergency Medicine in Meridian, MS. Organization (NPI-2).
NPI number1992563969
StatusActive
Last updated in NPPESMar 13, 2024
Details
- NPI
- 1992563969
- Entity type
- Organization (NPI-2)
- Legal business name
- Bonita Emergency Group, LLC
- Organization subpart
- No
- Enumeration date
- Mar 13, 2024
- Certification date
- Mar 13, 2024
- Last updated
- Mar 13, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
1314 19th AveMeridian, MS 39301-4116
Phone 601-483-0011 · Fax 601-483-4384
Mailing address
200 Corporate BlvdLafayette, LA 70508-3870
Phone 800-893-9698
Authorized official
Lisha C Falk
Vp Of Contracting
3376091221
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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