BONNA BENJAMIN (NPI# 1861408015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861408015 |
| Entity Type | Individual |
| Full Name | BONNA BENJAMIN |
| Credential | MD |
| Practice Address |
1901 Medi Park Dr Ste 2051 Amarillo TX 79106-2169 |
| Mailing Address |
1400 Wallace Blvd Attn: Credentialing Dept Amarillo TX 79106-1708 |
| Practice Telephone | 8064684300 |
| Practice Fax Number | 8064684398 |
| Mailing Telephone | 8064684300 |
| Mailing Fax Number | 8064684398 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | J8911 | TX | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
J8911 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100027640A | 05 | |
| TX | 124606807 | 05 | |
| TX | 124606806 | 05 | |
| NM | J8716 | 05 |
| Street Address |
1901 MEDI PARK DR STE 2051 |
| City | AMARILLO |
| State | TX |
| Zip Code | 79106-2169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003815325 | Stanley D Cook | Radiology | 1901 Medi Park Dr, Suite 2050, Amarillo, TX 79106-2110 | 2005-07-19 |
| 1396225496 | Lorelei Anne Johnson | Registered Nurse | 1901 Medi Park Dr, Amarillo, TX 79106-2110 | 2018-08-17 |
| 1184179293 | Viviana Whatley | Occupational Therapy Assistant | 1901 Medi Park Dr, Suite 2048, Amarillo, TX 79106-2110 | 2016-08-18 |
| 1891145959 | Beatriz Rey | Speech-Language Pathologist | 1901 Medi Park Dr, Suite 2048, Amarillo, TX 79106-2110 | 2016-06-20 |
| 1952755613 | Blaire Black | Speech-Language Pathologist | 1901 Medi Park Dr, Suite #2048, Amarillo, TX 79106-2110 | 2016-04-19 |
| 1912365461 | Corbie Nathaniel Grimes II | Counselor | 1901 Medi Park Dr, Suite 1038, Amarillo, TX 79106-2110 | 2016-01-28 |
| 1063887776 | Nicole Feagan | Speech-Language Pathologist | 1901 Medi Park Dr, Suite 2048, Amarillo, TX 79106-2110 | 2015-12-07 |
| 1902279573 | Krista Raquel Reta | Occupational Therapy Assistant | 1901 Medi Park Dr, Suite 2048, Amarillo, TX 79106-2110 | 2015-11-04 |
| 1164892956 | Amarillo Pediatric Clinic, Pllc | Nurse Practitioner | 1901 Medi Park Dr, Ste 65, Amarillo, TX 79106-2110 | 2015-10-06 |
| 1407226251 | Cassie Cleavinger | Speech-Language Pathologist | 1901 Medi Park Dr, Suite 2048, Amarillo, TX 79106-2110 | 2015-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773205 | Nisha Patel | Pharmacist | 1600 S Western Street, Amarillo, TX 79106 | 2020-09-01 |
| 1043851769 | Diana Moore | Pharmacist | 6010 Amarillo Blvd W (119), Amarillo, TX 79106 | 2019-10-03 |
| 1164988127 | Wade Family Services Pllc | Counselor | 1901 Medi Park Dr Suite 130, Amarillo, TX 79106 | 2019-02-14 |
| 1255802963 | Jennifer Cockrum | Hospitalist | Bsa Hospitalist, 1600 Wallace Blvd., Amarillo, TX 79106 | 2018-12-07 |
| 1346736691 | Denise Mills Donnell | Social Worker | 6010 Amarillo Bouldevard West Clc-b, Amarillo, TX 79106 | 2018-07-10 |
| 1124525472 | Abigail Batson | Student in an Organized Health Care Education/Training Program | 1400 S Coulter Street, Suite 1500, Amarillo, TX 79106 | 2018-04-11 |
| 1053812743 | Moc Amarillo, LLC | Skilled Nursing Facility | 1540 Research St., Amarillo, TX 79106 | 2018-02-27 |
| 1013459437 | Larry G. Schulz | Durable Medical Equipment & Medical Supplies | 1901 Medi Park Dr Ste 219, Amarillo, TX 79106 | 2016-11-16 |
| 1922453315 | Omar Saeed M Alzhrani | Student in an Organized Health Care Education/Training Program | 1400 S. Coulter - Suite 5100, Amarillo, TX 79106 | 2016-05-04 |
| 1972967529 | David Wayne Hohon | Internal Medicine | Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 | 2016-04-11 |
| Find all providers in zip 79106 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508808833 | Janet Meller | Surgery | 1400 S Coulter St, Amarillo, TX 79106-1786 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255775169 | Natasha Corbitt | Surgery | 1935 Medical District Dr Ste D2000, Dallas, TX 75235-7701 | 2013-04-22 |
| 1821327362 | South Texas Health Alliance | Surgery | 528 North Union Street, Suite 250, New Braunfels, TX 78130 | 2009-12-11 |
| 1356519565 | Children's Physician Services of South Texas | Surgery | 3533 S Alameda St Ste 302, Corpus Christi, TX 78411-1721 | 2008-02-11 |
| 1821271503 | Charles E. Baldwin Md | Surgery | 18866 Stone Oak Pkwy # 103-21, San Antonio, TX 78258-4180 | 2007-12-17 |
| 1801845318 | Ambrosio Hernandez IIi | Surgery | 1120 E Ridge Rd, Mcallen, TX 78503-5411 | 2006-05-10 |
| 1477516201 | Jane Franklin Goldthorn | Surgery | 4102 22nd Pl, Lubbock, TX 79410-1122 | 2006-04-11 |
| 1528049723 | Charles Thomas Black | Surgery | 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 | 2005-11-07 |
| 1578554895 | William W Spurbeck | Surgery | 5340 El Paso Dr Ste M, El Paso, TX 79905-2837 | 2005-11-04 |
| 1104820554 | Charles Eugene Baldwin | Surgery | 502 Madison Oak Drive, Suite 330, San Antonio, TX 78258-4298 | 2005-06-13 |
| 1649870304 | Parkhill Surgery Center Plano, LLC | Surgery | 7000 W Plano Pkwy, Plano, TX 75093-8466 | 2020-10-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.