Active NPI
Richard B. Bonner, M.D.
- Pediatric Critical Care Medicine Physician
- Temple, TX
National Provider Identifier
1659331841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- J8468
- Practice address
- 1901 SW H K Dodgen Loop
Temple, TX 76502-1814 - Phone
- (254) 935-4000
- NPI assigned
- Mar 23, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | J8468 | TX | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | J8468 | TX | Primary |
Addresses
Primary practice location
1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8J5012 | Other | TX | BLUE SHIELD |
| 1117681-04 | Medicaid | TX | |
| P00036792 | Other | TX | RR/MEDICARE |
| 1117681-06 | Other | TX | CSHCN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rbonner13183@direct.sw.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22656 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Clinic | Pediatrics | Current | Accepting new patients |
| Scott & White Clinic | Pediatrics | Current | Accepting new patients |
| Scott & White Hospital - Taylor | Past | Accepting new patients | |
| Scott & White Memorial Hospital | Past | Accepting new patients |
Locations
101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100
1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 742-9256
2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459
Interoperability endpoints
- rbonner13183@direct.sw.org
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Taylor, TX
- NPI 1659366557
-
- General Acute Care Hospital
- Temple, TX
- NPI 1477516466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1659331841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "800-994-0371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 SW H K DODGEN LOOP",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021814",
"telephone_number": "254-935-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "RICHARD",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "J8468",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "TX",
"license": "J8468",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "8J5012",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1117681-04",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "P00036792",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "1117681-06",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rbonner13183@direct.sw.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1901 SW H K Dodgen Loop",
"city": "Temple",
"state": "TX",
"country_code": "US",
"postal_code": "765021814",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.