Active NPI
Phil Bome
- Family Nurse Practitioner
- Plano, TX
National Provider Identifier
1346987674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1076988
- Practice address
- 5040 Tennyson Pkwy
Plano, TX 75024-3002 - Phone
- (469) 265-4748
- NPI assigned
- May 18, 2022
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1076988 | TX | Primary |
Addresses
Primary practice location
5040 Tennyson Pkwy
Plano, TX 75024-3002
Mailing address
9976 Bradford Grove Dr
Frisco, TX 75035-3003
Phone (469) 585-5166
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1076988 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1346987674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9976 BRADFORD GROVE DR",
"city": "FRISCO",
"state": "TX",
"postal_code": "750353003",
"telephone_number": "469-585-5166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5040 TENNYSON PKWY",
"city": "PLANO",
"state": "TX",
"postal_code": "750243002",
"telephone_number": "469-265-4748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOME",
"first_name": "PHIL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-18",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1076988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.