BONNIE C CARTER (MD) – Family Medicine Physician, NPI 1063417632

BONNIE C CARTER (MD) is a healthcare provider. based in Odessa, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. L5693 (TX). The NPI Number for BONNIE C CARTER (MD) is 1063417632

Main info

Female
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
BONNIE C CARTER (MD)
NPI
1063417632
Phone
(432) 640-6712
Address
1940 E 42ND ST
Enumeration Date
20 June 2005
Deactivation Date
20 March 2006
Reactivation Date
12 June 2006
Last Update Date
19 October 2017

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
5092789800
Group Practice PAC ID
2163326281
Professional Enrollment ID
I20040826000173
Address ID
TX797204113BI1608X700X400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

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Provider Addresses for BONNIE C CARTER (MD)

  • MCH Center for Primary Care – 42nd Street, 1940, East 42nd Street (Chris Kyle Memorial Highway), Hillside, Odessa, Ector County, Texas, 79762, United States

    ODESSA, TX 797625840

    Phone: (432) 640-6712

    Fax: (432) 640-4788

    Type: Location

  • PO BOX 2129

    ODESSA, TX 797602129

    Phone: (432) 640-6712

    Fax: (432) 640-4788

    Type: Mailing

  • 421 E 1st St

    Dumas, TX 790293201

    Phone: (806) 935-5094

    Fax: (806) 935-3990

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 70 Open Payments records for all available years, with a total value of $1,419.

Total Amount is formed as General ($1,419) + Research ($0) + Ownership ($0) = $1,419.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Lilly USA, LLC ($505).

Total Amount

$1,419

General + Research + Ownership

Payments

70

Total payment records

General Amount

$1,419

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-08-26

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
I20040826000173IFamily PracticeTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes10159$0
J0696Injection, ceftriaxone sodium, per 250 mg7217$0
36415Insertion of needle into vein for collection of blood sample5346$0
96372Injection of drug or substance under skin or into muscle2818$0
99213Established patient office or other outpatient visit, 20-29 minutes2822$0
View full utilization report →

Insurance plans in this area (ZIP 79762)

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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: 2163326281View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX
Cardiovascular Disease (Cardiology)TX
O B S T E T R I C S/ G Y N E C O L O G YTX
Internal Medicine, Cardiovascular Disease (Cardiology)TX
Pulmonary DiseaseTX
General SurgeryTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for BONNIE C CARTER (MD)?
BONNIE C CARTER (MD) — NPI 1063417632 — is the standard way to identify this listing.
Is BONNIE C CARTER (MD) still practicing?
BONNIE C CARTER (MD) is currently listed as active in the public NPI registry.
What taxonomy line describes BONNIE C CARTER (MD)?
For research purposes, treat BONNIE C CARTER (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect BONNIE C CARTER (MD) on a map?
Expect Odessa, Texas as a primary anchor for BONNIE C CARTER (MD) unless the record lists multiple sites.
Why does BONNIE C CARTER (MD) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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