NPIMap

Individual provider Active NPI

Clark Andrew Bonham, MD

  • Transplant Surgery Physician
  • Kansas City, MO
National Provider Identifier
1528083284
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
2025013416 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 701-5200
Fax
(816) 302-9939
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Oklahoma College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Childrens Mercy Hospital 143 clinicians

Practice addresses (Care Compare)

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

5808 W 110TH St
Overland Park, KS 66211-2504
Phone (913) 696-8000

Hospital & facility affiliations

  • The Children'S Mercy Hospital Hospital, Kansas City, MO, CCN 263302

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250508002825 MO Practitioner - Pediatric Medicine 5890796999 Reassigns benefits to 1 organization
I20250715000214 KS Practitioner - Pediatric Medicine 5890796999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-51288KSMDTransplant Surgery Physician
2025013416MOMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Mercy Hospital CurrentSince Apr 30, 2025 Accepting new patients
The Children'S Mercy Hospital CurrentSince Apr 30, 2025 Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 2025013416 MO Primary
Transplant Surgery Physician 204F00000X 04-51288 KS

Addresses

NPPES NPI Registry

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Provider Enrollment Dept
Kansas City, MO 64108-4619
Phone (816) 701-5200

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00C507500MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 25, 2025.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1528083284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHAM",
        "first_name": "CLARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MO",
            "license": "2025013416",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "KS",
            "license": "04-51288",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C507500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.