Kathryn Bonner, DPT
NPI 1659551802ActiveIndividual· Physical Therapist· Vicksburg, MS
Physical Therapist (DPT) with Elite Performance and Rehab, LLC, practicing in Vicksburg, Mississippi. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1659551802 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Nov 5, 2007 |
| Last updated in NPPES | Nov 5, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT3942 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (MS) |
|---|
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Elite Performance and Rehab, LLCVicksburg, MS · 5 clinicians
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