Carla Beth Bonner, PHARM D

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

225176 Issued in OK

Practice address

2008 W Grant Ave
Pauls Valley, OK 73075-9230

Phone

(405) 238-7525

Fax

(405) 238-7135

NPI assigned

Nov 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Pauls Valley, OK
  • NPI 1497772511
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1649935834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 W GRANT AVE",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730759230",
            "telephone_number": "405-238-7525",
            "fax_number": "405-238-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 W GRANT AVE",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730759230",
            "telephone_number": "405-238-7525",
            "fax_number": "405-238-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "CARLA",
        "middle_name": "BETH",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13816",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "225176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deana Kay Andrews, ARNP
• Brett Avery Baldwin, APRN
• Michaela Kathrine Barger, LPC CANDIDATE
• Bio-Medical Applications of Oklahoma, Inc.
• Carla Ann Boettler, DPH
• Olga Bostic, LPC
• Larry Donnell Bowler, MD
• Julie Lynn Bowring, PA-C
• Melody Brantley
• Brian a Allee DO PC

• Community/Retail Pharmacy in Pauls Valley, OK
• Providers in Pauls Valley, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.