Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack E Bonham, PA

Individual provider Physician Assistant · NPI 1396058608

Jack E Bonham, PA is a Physician Assistant in Beech Grove, Indiana. Qualified in 2010, 16 years ago. Practices with Recover Together Inc, a 143-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
16
Licensed in
IN
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1600 Albany St
Beech Grove, IN 46107-1541
Phone: (317) 802-3151
Fax: (317) 870-0499
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1500 N Ritter Ave Ste 500, Indianapolis, IN 46219-3027 — (317) 355-5457

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10001193A (IN)

Record details

NPI number1396058608
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 16, 2010
Last updated in NPPESJune 25, 2021
Certification dateJune 25, 2021
Mailing addressPo Box 7112, Dpt 31, Indianapolis, IN 46207-7112

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Recover Together Inc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations13 on file with Medicare

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