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

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

Other providers in Vicksburg