David Bradley Bonham Jr., CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1167246 Issued in TX

Practice address

2501 Jimmy Johnson Blvd Ste 110
Port Arthur, TX 77640-2011

Phone

(409) 344-4466

NPI assigned

Jun 19, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mid County Medical Group PAGroup PAC ID 6305875923, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid County Medical Group PA

  • Internal Medicine Physician
  • Port Arthur, TX
  • NPI 1568470136

  Family

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1003650607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8849 PINEWOOD DR APT 8203",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776401185",
            "telephone_number": "832-744-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD STE 110",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402011",
            "telephone_number": "409-344-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHAM",
        "first_name": "DAVID",
        "middle_name": "BRADLEY",
        "name_suffix": "Jr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1167246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanna Elizabeth Bloss, NP
• Blue Zone Precision Health Medical - Port Arthur, PLLC
• Tanisha Bodden, RDN., LD.
• Olayemi Olaoluwa Bolarinwa, MD
• Briana Bollinger, PTA
• Darla Denise Booth, CSFA
• Stephen Bosworth, PTA
• Jasmine Yvonne Botley, LVN
• Andrew Botrous, DENTAL STUDENT
• Richard G Bowling, DPM

• Family Nurse Practitioner in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.