Active NPI
Scott Ronald Bonham, RPH
- Pharmacist
- South Padre Island, TX
National Provider Identifier
1235440033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36014
- Practice address
- 1500 Padre Blvd
South Padre Island, TX 78597-6726 - Phone
- (956) 761-3476
- Fax
- (956) 761-4146
- NPI assigned
- Jun 25, 2010
- Last updated
- Nov 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36014 | TX | Primary |
Addresses
Primary practice location
1500 Padre Blvd
South Padre Island, TX 78597-6726
Mailing address
1500 Padre Blvd
South Padre Island, TX 78597-6726
Phone (956) 761-3476
Other practice location 1
118 E Harrison Avenue
CVS Pharmacy
Harlingen, TX 78550
Phone (956) 423-4778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36014 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1235440033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 PADRE BLVD",
"city": "SOUTH PADRE ISLAND",
"state": "TX",
"postal_code": "785976726",
"telephone_number": "956-761-3476",
"fax_number": "956-761-4146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 PADRE BLVD",
"city": "SOUTH PADRE ISLAND",
"state": "TX",
"postal_code": "785976726",
"telephone_number": "956-761-3476",
"fax_number": "956-761-4146"
}
],
"practiceLocations": [
{
"address_1": "118 E Harrison Avenue",
"address_2": "CVS PHARMACY",
"address_purpose": "LOCATION",
"city": "Harlingen",
"state": "TX",
"postal_code": "78550",
"country_code": "US",
"telephone_number": "956-423-4778",
"fax_number": "401-733-0472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BONHAM",
"first_name": "SCOTT",
"middle_name": "RONALD",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-25",
"last_updated": "2020-11-17",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "36014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Padre Island, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.