Bingham Dermatology Group, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5198 Issued in AZ

Legal business name

BINGHAM DERMATOLOGY GROUP, LLC

Practice address

2855 E Brown Rd
Suite 22
Mesa, AZ 85213-4213

Phone

(111) 111-1111

NPI assigned

Mar 28, 2013

Last updated

Mar 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeremy Kempton Bingham, D.O.NPI 1235391889

Title

Owner / Managing Member

Phone

(111) 111-1111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeremy K Bingham, DO

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1235391889
  Medicare reassignment Care Compare group NPD Authorized official
• Clark Richard Bingham, PA-C

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1730775396
  Medicare reassignment Care Compare group
• Ryan Kirk Bingham, PA

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1548779713
  Medicare reassignment Care Compare group
• David Alexander Kelly, M.D.

  • Plastic Surgery Physician
  • Scottsdale, AZ
  • NPI 1821259722
  Medicare reassignment NPD
• Jonathan Harris, PA-C

  • Medical Physician Assistant
  • Goodyear, AZ
  • NPI 1598251142
  Medicare reassignment
• Adam Craig Turner

  • Medical Physician Assistant
  • Tempe, AZ
  • NPI 1447725189
  Medicare reassignment
• Scott Randall Bingham

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1790648384
  NPD
• Yordanos Azene Habtegebriel, M.D.

  • Pulmonary Disease Physician
  • Arlington, TX
  • NPI 1053699694
  NPD (past)

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1083957906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 E BROWN RD",
            "address_2": "SUITE 22",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852134213",
            "telephone_number": "111-111-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 E BROWN RD",
            "address_2": "SUITE 22",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852134213",
            "telephone_number": "111-111-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BINGHAM DERMATOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "KEMPTON",
        "authorized_official_title_or_position": "OWNER / MANAGING MEMBER",
        "authorized_official_telephone_number": "111-111-1111",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "5198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Joseph Binette, M.D.
• Shauna L Binette, A.N.P.
• Marcie Binford, PHARMD
• Lori Bingaman, CCP
• Laurie T Bingenheimer
• Clark Richard Bingham, PA-C
• Jeremy K Bingham, DO
• Ryan Kirk Bingham, PA
• Scott Randall Bingham
• Timothy Bingham, CNA

• Dermatology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.