Jennifer Cherry Bohannan

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

U3164 Issued in TX

Practice address

1402 W Avenue H
Temple, TX 76504-5342

Phone

(254) 771-8411

NPI assigned

Apr 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Nicole Cherry Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Texas a & M University System, HSC, College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbohannan203158@direct.sw.org

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.

• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Family Medicine

  NPD
• Scott and White Clinic

  • Radiation Oncology Physician
  • Waxahachie, TX
  • NPI 1821475153

  Family Medicine

  NPD
• Multicare Health System

  • Pediatrics Physician
  • Gig Harbor, WA
  • NPI 1225674963
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Scott & White Hospital - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)
• Scott & White Memorial Hospital

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  NPD (past)

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

• Scott & White Memorial Hospital

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  Care Compare affiliation
• Scott & White Memorial Hospital

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1578502613
  Care Compare affiliation

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1891283313",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 W AVENUE H",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765045342",
            "telephone_number": "254-771-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 3rd St SE Ste 240",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723771",
            "country_code": "US",
            "telephone_number": "253-697-1420",
            "fax_number": "253-697-1439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHANNAN",
        "first_name": "JENNIFER",
        "middle_name": "CHERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61145650",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U3164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbohannan203158@direct.sw.org",
            "affiliation": "N",
            "address_1": "1402 W Avenue H",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765045342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CHERRY",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Body, Mind & Spine Chiropractic LLC
• Robin Nicole Boeck, M.D.
• Karla Boeta-Lopez, MD
• Carl David Boethel, M.D.
• Vanessa Jean Boggiano, DO
• William Todd Bohannon, M.D.
• Rachael Elizabeth Boise, PA-C
• Shames Foaad Ali Bolad
• Fernando Alfredo Bolanos, M.D.
• Karla P Bolanos, MD

• Family Medicine Physician in Temple, TX
• Providers in Temple, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.