Bonnie Harris, FNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1088590 Issued in TX

Practice address

1500 Wildcat Dr Ste C
Portland, TX 78374-2826

Phone

(361) 643-9800

Fax

(361) 643-5112

NPI assigned

Jul 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles Gregory DO PAGroup PAC ID 6002838919, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Charles Gregory, DO PA

  • Family Medicine Physician
  • Portland, TX
  • NPI 1952420804
  Medicare reassignment Care Compare group NPD
• Coastal Children'S Clinic PA

  • Pediatrics Physician
  • Corpus Christi, TX
  • NPI 1164471116
  Medicare reassignment NPD

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1740916808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WILDCAT DR STE C",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742826",
            "telephone_number": "361-643-9800",
            "fax_number": "361-643-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WILDCAT DR STE C",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742826",
            "telephone_number": "361-643-9800",
            "fax_number": "361-643-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BONNIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1088590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisha Lynette Griffitt, LAT,ATC
• Gulf Coast Psychology PLLC
• H-E-B, LP
• Christopher Joseph Hansen, LPC,NCC
• Harbor Hospice of Portland, LP
• Andrea Dawn Hartquist, FNP
• Nadia Hatami Fardy
• Kathy Haywood, ABOC
• Patricia Gail Helms
• Jennifer Hendrix, DO

• Pediatric Nurse Practitioner in Portland, TX
• Providers in Portland, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.