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NICOLE RAASTAD BONHAM MA
NPI 1336572981
Counselor - Professional in Johnson City, TN

Active since August 19, 2013PECOS Enrolled
109 W WATAUGA AVE, JOHNSON CITY, TN 37604(423) 232-2600(423) 467-3644 Get Directions Write a Review

NPPES record last updated: October 23, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Raastad Bonham Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE RAASTAD BONHAM MA (NPI 1336572981) is an individual professional provider in Johnson City, Tennessee, licensed in Tennessee (3525) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336572981
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameNICOLE RAASTAD BONHAMCredential: MA
Location Address109 W WATAUGA AVEJohnson City, TN 37604-5621
Mailing Address1167 Spratlin Park Dr, Po Box 9054Gray, TN 37615-6205 · (423) 467-3600 · Fax (423) 467-3644
Phone(423) 232-2600
Fax(423) 467-3644
Sole ProprietorNo
Enumeration DateAugust 19, 2013
Last NPPES UpdateOctober 23, 2015
✔ NPI 1336572981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TN · 3525
Also ListedCounselorTaxonomy 101Y00000X
109 W WATAUGA AVE, Johnson City, TN 37604
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Other Names 1

Former Name (1)Nicole L Raastad Ma

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Raastad Bonham Ma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Bonham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Frontier Health
Same address
Mental Health (Including Community Mental Health Center)
109 W WATAUGA AVE
Johnson City, TN 37604
  • Reassigned Medicare billing, Tennessee enrollment
  • 126 clinicians in this Medicare group
NPI 1386700383 (423) 232-2600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE KATKO BS
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
MATTHEW M MIDKIFF LPC, MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
KIM MARIE DICKSON BACHELORS
Case Manager/Care Coordinator
109 W WATAUGA AVE, WATAUGA BEHAVIORAL HEALTH
JOHNSON CITY, TN 37604
Washington County (423) 232-2788
MR. JONATHAN JUNIOR PERKINS MED
Counselor
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
HANNAH T SHANNON LPC/ MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
HALEY N CIGARROA LPC/ MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
ISAAC LEE MARTIN JR. MRC CRC
Personal Emergency Response Attendant
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
ADAM WAYNE DAVIS
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Bonham's NPI number?

The NPI number for Nicole Bonham is 1336572981. It was assigned to this individual provider in the NPPES registry on August 19, 2013. The provider is also known as Nicole L Raastad Ma.

Where is Nicole Bonham located?

Nicole Bonham practices at 109 W Watauga Ave, Johnson City, TN 37604. The listed phone number is (423) 232-2600.

What is Nicole Bonham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Nicole Bonham enrolled in Medicare?

Yes. Nicole Bonham is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Bonham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Bonham reassigns Medicare benefits to Frontier Health (Johnson City, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Bonham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Bonham accept?

Health plans from BlueCross BlueShield of Tennessee list Nicole Bonham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Bonham was last updated on October 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.