Amber R Bonema, FNP-BC, ENP-C

Individual provider Active NPI Family Nurse Practitioner · Ashland City, TN

NPI 1275360620 · NPPES record last updated Jul 21, 2026

Key facts

NPI
1275360620
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
37166 (TN)
Practice address
302 N Main St
Ashland City, TN 37015-1306
Phone
(615) 792-2280
Fax
(615) 412-2053
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 8

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLC (181 clinicians)

Practice addresses (Care Compare)

1466 Tiny Town Rd
Suite C
Clarksville, TN 37042-8294
Phone (931) 503-7093

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241209000569 TN Practitioner - Nurse Practitioner 7810423357 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC Current
since Sep 5, 2024
Accepting new patients
Fast Pace Medical Clinic PLLC Current
since Sep 5, 2024
Accepting new patients

Locations

235 Highway 52 W
Portland, TN 37148
Phone (615) 802-1087

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 37166 TN
Family Nurse Practitioner 363LF0000X 37166 TN Yes

Addresses

Primary practice location

302 N Main St
Ashland City, TN 37015-1306

Mailing address

302 N Main St
Ashland City, TN 37015-1306
Phone (615) 792-2280

Other practice location 1

304 N Main St
Ashland City, TN 37015-1306
Phone (615) 821-2273

Other names

  • Amber Desota Former name

Other providers in Ashland City, TN

All providers in Ashland City, TN · Family Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.