Individual provider Active NPI

Bindu Bennuri, MD

  • Allergy & Immunology (Internal Medicine) Physician
  • Northport, AL
National Provider Identifier
1063511202
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
22399 Issued in AL
Practice address
2701 20TH Avenue
Northport, AL 35476-3832
Phone
(205) 333-5900
Fax
(205) 333-6090
NPI assigned
Sep 22, 2006
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 22399 AL Primary

Addresses

Primary practice location

2701 20TH Avenue
Northport, AL 35476-3832

Mailing address

2701 20TH Avenue
Northport, AL 35476-3832
Phone (205) 333-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000566 AL Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 6901794171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

920 Rose Dr
Northport, AL 35476-3363
Phone (205) 339-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22399ALMDAllergy & Immunology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bama Pedicatrics LLC CurrentSince Jan 1, 2005 Accepting new patients
Military Spousal Support Center Current Accepting new patients

Locations

920 Rose Dr
Northport, AL 35476
Phone (205) 333-5900

Interoperability endpoints

  • Direct secure messaging: bindu.bennuri@bamapeds.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1063511202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 20TH AVENUE",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763832",
            "telephone_number": "205-333-5900",
            "fax_number": "205-333-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 20TH AVENUE",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763832",
            "telephone_number": "205-333-5900",
            "fax_number": "205-333-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNURI",
        "first_name": "BINDU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "AL",
            "license": "22399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.