Individual provider Active NPI

Paul Linford Bingham, O.D.

  • Optometrist
  • Boise, ID
National Provider Identifier
1063852119
Registry record updated Jan 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100277 Issued in ID
Practice address
7447 W Emerald St
Ste 105
Boise, ID 83704-5003
Phone
(208) 322-1642
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100277 ID Primary

Addresses

Primary practice location

7447 W Emerald St
Ste 105
Boise, ID 83704-5003

Mailing address

3221 S Oxbow Dr
Nampa, ID 83686-4905
Phone (208) 280-9762

Other identifiers 1

IdentifierTypeStateIssuer
1063852119MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100277IDMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453507200000",
    "number": "1063852119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 S OXBOW DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836864905",
            "telephone_number": "208-280-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W EMERALD ST",
            "address_2": "STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045003",
            "telephone_number": "208-322-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "PAUL",
        "middle_name": "LINFORD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2016-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063852119",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.