SALLY DIANE BONHAM BSN, MSN, FNP, IBCLC
NPI 1811750078
Nurse Practitioner - Family in Waco, TX
About Sally Diane Bonham Bsn, Msn, Fnp, Ibclc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SALLY DIANE BONHAM BSN, MSN, FNP, IBCLC (NPI 1811750078) is an individual family provider in Waco, Texas, licensed in Texas (1182184) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Sally Diane Bonham Bsn, Msn, Fnp, Ibclc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 76708 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WACO, TX 76708
WACO, TX 76708
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 Sally Bonham's NPI number?
The NPI number for Sally Bonham is 1811750078. It was assigned to this individual provider in the NPPES registry on January 31, 2024. The provider is also known as Sally Diane Taylor.
Where is Sally Bonham located?
Sally Bonham practices at 3500 Hillcrest Dr Ste 1, Waco, TX 76708. The listed phone number is (254) 741-6641.
What is Sally Bonham's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Sally Bonham enrolled in Medicare?
Yes. Sally Bonham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Sally Bonham accept?
Health plans from Blue Cross and Blue Shield of Texas list Sally 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 Sally Bonham was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Sally Diane Bonham, BSN, MSN, FNP, IBCLC · NPI 1811750078
Family physician in Waco, Texas. Individual provider, active in the CMS NPPES registry since January 31, 2024.
## Identity
- **NPI:** 1811750078 (Entity type: Individual)
- **Enumerated:** January 31, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1182184 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3500 HILLCREST DR STE 1, Waco, TX 76708-3144
- **Phone:** (254) 741-6641 · **Fax:** (257) 453-7469
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** October 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1811750078) · Data from the CMS NPPES public registry.