Lydia M Bonner, NP is a medicare enrolled "Nurse Practitioner - Family" in Repton, Alabama. Her current practice location is
1328 Old Stage Rd, Repton, Alabama. You can reach out to her office (for appointments etc.) via phone at
(251) 593-1227.
Lydia M Bonner is licensed to practice in Alabama (license number 115121) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1386250710.
Provider's Profile
| Full Name | Lydia M Bonner |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1328 Old Stage Rd, Repton, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1386250710
- Provider Enumeration Date: 09/21/2020
- Last Update Date: 12/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 8921416538
- Enrollment ID: I20210421000021
Medical Identifiers
Medical identifiers for Lydia M Bonner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386250710 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 115121 (Alabama) | Primary |
| 261Q00000X | Clinic/center | (Alabama) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lydia M Bonner allows following entities to bill medicare on her behalf.
| Entity Name | Escambia County Alabama Community Hospitals, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124073879
PECOS PAC ID: 4385616119
Enrollment ID: O20040811000712 |
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| Entity Name | Monroe County Health Care Authority |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992178552
PECOS PAC ID: 2668365859
Enrollment ID: O20160321001799 |
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| Entity Name | Ies Alabama Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053027276
PECOS PAC ID: 5395105183
Enrollment ID: O20230712000361 |
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| Entity Name | Gulf Coast Health & Wellness Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588402341
PECOS PAC ID: 8820528656
Enrollment ID: O20250210001847 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lydia M Bonner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lydia M Bonner, NP
1328 Old Stage Rd,
Repton, AL 36475-9433
Ph: (251) 593-1227 | Lydia M Bonner, NP
1328 Old Stage Rd,
Repton, AL 36475-9433
Ph: (251) 593-1227 |
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