Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kathryn Bonner, DPT

Individual provider Physical Therapist · NPI 1659551802

Kathryn Bonner, DPT is a Physical Therapist in Private Practice in Vicksburg, Mississippi. Qualified in 2005, 21 years ago. Practices with Elite Performance and Rehab, LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
21
Licensed in
MS
In the registry since
2007
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

1990 S Frontage Rd Ste J
Vicksburg, MS 39180-5232
Phone: (601) 883-1983
Fax: (601) 883-1938
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT3942 (MS)

Record details

NPI number1659551802
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 5, 2007
Last updated in NPPESNovember 5, 2007
Mailing address1990 S Frontage Rd Ste J, Vicksburg, MS 39180-5232

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Elite Performance And Rehab, Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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