DAVID BRADLEY JR. BONHAM (CNP) – Family Nurse Practitioner, NPI 1003650607

DAVID BRADLEY JR. BONHAM (CNP) is a healthcare provider. based in Port arthur, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. 1167246 (TX). The NPI Number for DAVID BRADLEY JR. BONHAM (CNP) is 1003650607

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
DAVID BRADLEY JR. BONHAM (CNP)
NPI
1003650607
Phone
(832) 744-2375
Address
8849 PINEWOOD DR APT 8203
Enumeration Date
19 June 2024
Last Update Date
19 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4093444466
Graduation Year
2024 (2 years ago)
PAC ID
5092254292
Group Practice PAC ID
6305875923
Professional Enrollment ID
I20240903000887
Address ID
TX776274145NE1132XAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for DAVID BRADLEY JR. BONHAM (CNP)

  • 8849 PINEWOOD DR APT 8203

    PORT ARTHUR, TX 776401185

    Phone: (832) 744-2375

    Type: Mailing

  • 2501 JIMMY JOHNSON BLVD STE 110

    PORT ARTHUR, TX 776402011

    Phone: (409) 344-4466

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240903000887INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77640)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305875923View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Pediatric Medicine, Internal MedicineTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I use this page to confirm DAVID BRADLEY JR. BONHAM (CNP)'s NPI?
Yes. DAVID BRADLEY JR. BONHAM (CNP) is listed with NPI 1003650607 in the public NPI dataset.
Is DAVID BRADLEY JR. BONHAM (CNP) still practicing?
DAVID BRADLEY JR. BONHAM (CNP) is currently listed as active in the public NPI registry.
What is DAVID BRADLEY JR. BONHAM (CNP) best known for clinically?
Directory data describes DAVID BRADLEY JR. BONHAM (CNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does DAVID BRADLEY JR. BONHAM (CNP) list a practice location?
Patients near Port Arthur, Texas may find DAVID BRADLEY JR. BONHAM (CNP) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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